Lateral Canal Benign Paroxysmal Positional Vertigo: A Review of its assessment and Treatment Options

Lateral Canal Benign Paroxysmal Positional Vertigo: A Review of its assessment and Treatment Options

L. Califano*, F. Salafia, MG. Melillo and S. Mazzone

Abstract: Benign paroxysmal positional vertigo (BPPV) is the most common vestibular syndrome. It is characterized by short lasting spelling of vertigo when patient change his/her head position in the space. The putative pathogenesis is the dislodgement of otoliths from the utricular macula to semicircular canals. The most frequent form is posterior canal BPPV, whereas lateral canal BPPV is reported in about 20% of cases. Various forms of lateral canal BPPV are reported: geotropic variant, apogeotrophic variant and, more recently, a Direction-fixed nystagmus variant, which is the rarest form. Mechanisms other than canalar lithiasis could be involved in the pathogenesis of lateral canal BPPV, namely situations of “heavy cupula’’ and “light cupula”. Liberatory therapy is very effective and the shift from an apogeotrophic form to a geotropic form is considered useful for a better outcome. Aim of the paper is to present a review of current pathophysiological hypothesis about lateral canal BPPV, its assessment and therapeutic options.