• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.243-250
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• 2016

Objective: We report a case of a 73-year-old Korean male with vertigo and nausea, both of which were brought about by head repositioning. The condition was diagnosed as benign paroxysmal positional vertigo (BPPV).Method: The patient was treated with acupuncture, electroacupuncture, cupping, transcutaneous electrical nerve stimulation (TENS), and herbal medicine (Bosimsahwacheonggan-tang [補心瀉火淸肝湯]). We conducted the vertigo symptoms scale (VSS) and the dizziness handicap inventory (DHI) to evaluate the degree of the patient’s symptoms.Results: Vertigo and nausea started to improve after the administration of Bosimsahwacheonggan-tang, but although the patient took the anti-vertigo medication and a tranquilizer after the symptoms became aggravated, no prominent improvements could be observed.Conclusion: These results suggest that traditional Korean medical treatment may be effective in treating peripheral vertigo due to BPPV.

• The Journal of Internal Korean Medicine
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• v.38 no.4
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• pp.479-490
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• 2017

Objectives: This study provides evidence for clinical practices by analyzing present clinical Korean medicine articles about benign paroxysmal positional vertigo (BPPV). Methods: Articles published up to July, 2017 were found by searching "BPPV", "Benign positions", and "Vertigo" as keywords in three domestic electric databases (i.e., OASIS, NDSL, RISS). Results: The initial search resulted in 228 articles; however, only 20 articles satisfied the selection criteria and were analyzed. Of these, 40% were published in the Journal of Korean Oriental Internal Medicine, and 35% were published in 2003. When diagnosing BPPV patients, VAS scores are primarily used for clinical assessments rather than objective diagnostic tools. Banhabaekchulcheonmatang was the most frequent herbal medicine used to treat BPPV, and the most commonly used therapeutic acupuncture point was Jok-samni (ST36). The most common diagnosis of BPPV was dam-eum according to nine studies. Conclusions: Systematic and large-scale research for the standardization of BPPV treatment is needed.

• Journal of Sasang Constitutional Medicine
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• v.15 no.2
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• pp.101-110
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• 2003

Benign paroxysmal positional vertigo(BPPV) is the most common peripheral vestivular disorder that is featured with paroxysmal vertigo caused by position changes. For a long time, it has been believed that the rendition is caused by inorganic particles in the cupula of the posterior semicircular canal. In the book 'DongyiSuseBowon(東醫壽世保元)', vertigo has been mentioned So-Yang-Sang-Pung syndrome and fever-aversive syndrome for Yin deficiency of So-Yang-In. Hyeong-Bang-Do-Jeok-San(荊防導赤散) is used at So-Yang-Sang-Pung and Gyeol-Hyung syndrome of So-Yang-In. Three patients in the cases have been suffered from vertigo, nausea and hot flushes etc. These patients were classified as So-Yang-In by features in the face, bodyshape and personality patterns. All of them have been improved in vertigo and other symptoms with Hyeong-Bang-Do-Jeok-San for a few days. The result showed that So-Yang-In Hyeong-Bang-Do-Jeok-San was effective on vertigo and other symptoms of BPPV patients.

• Journal of Acupuncture Research
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• v.29 no.4
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• pp.1-6
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• 2012

Objectives : This study was done for reporting the effect of scratching method on patients with positional vertigo. Methods : We investigated 22 cases of patients with dizziness, and devided patients into two groups : We treated one group by complex oriental medical treatment with scratching method therapy, and did the other group by complex oriental medical treatment without scratching method therapy. Korean version of dizziness handicap inventory at baseline and final were used for evaluating the effect of the treatment. Results : 1. In scratching method group and non-scratching method group, compared with baseline, at final, Korean version of dizziness handicap inventory was significantly decreased. 2. At final, scratching method group showed significant decrease on Korean version of dizziness handicap inventory compared with non-scratching method group. Conclusions : Scratching method showed significant improvement in dizziness.

• Korean Journal of Clinical Laboratory Science
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• v.40 no.1
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• pp.62-70
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• 2008

Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities encountered in a dizzness clinic. Retrosepective review was performed for the patient's diagnosed as BPPV at Sunchon "S" hospital dizzness center. Variables for statistical analysis included age, sex, involved canal presence of recent head tramua, presence of chronic otitis media, history of middle ear surgery, underlying disease such as hypertension or diabetics, headache, central lesion. From July 2004 to May 2005, we sampled the 600 dizzness patient's who visited the dizzness center. Dizzness could be classified into BPPV, vestibulopathy. Among these patients, 256 patients had BPPV, 222 patients had vesibulopathy and 97 patients had Normal. Among these BPPV patients, 80 patients had lateral canalolithiasis BPPV (31.3%), 28 patients had lateral cupulolithiasis BPPV (10.9%), 90 patients had posterior canalolithiasis BPPV (35.2%), 7 patients had multicanalolithiasis BPPV (2.3%), 52 patients simultaneously had BPPV, other vestibular disease, and central lesion (20.3%).

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.199-209
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• 2020

Objective: The purpose of this paper is to report the improvement in a patient with benign paroxysmal positional vertigo (BPPV) treated with herbal medication based on the Shanghanlun disease pattern identification diagnostic system. Methods: According to the 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions,'the patient was diagnosed with Guorem-byung number 350 provision, and took Baekho-tang herbal medication for 15 days. The result of administration was evaluated using the Dizziness Handicap Inventory (DHI) and the Visual Analog Scale (VAS). Results: After administration of Baekho-tang for 15 days, based on the 350 provision of Baekho-tang diagnosed according to the Shanghanlun provisions, the DHI score decreased from 74 to 16 and the VAS score decreased from 10 to 1. Conclusions: The patient recovered from symptoms of BPPV. This case report suggests that the words '滑,''厥,''裏'on the 350 provision of Shanghanlun mean physical and psychological causes of BPPV in this case.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.43-48
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• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.43-48
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• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.734-739
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• 2009

Benign paroxysmal positional vertigo(BPPV) is the most common peripheral vestibular disorder clinically. It causes dizziness or vertigo, lightheadedness, imbalance, and nausea. by a change of position of the head with respect to gravity. BPPV is very well explained by mechanical consequences of loose debris within the inner ear and oriental medical theory of vertigo resulting from Phlegm(痰). Therefore, for treatment of BPPV, we can consider not only oriental medical therapy but also Canalith Repositioning Procedure. We report four improved cases of dizziness patient diagnosed BPPV and Dam Hun(痰暈) treated by canalith repositioning procedure and herbal medication and acupuncture.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.658-662
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• 2018

Background and Objectives The early assessment of treatment is not done for benign paroxysmal positional vertigo (BPPV) since the well-known phenomenon of fatigability after a repeated positional test can mimic successful treatment. The aim of this study is to evaluate the clinical implication of 'fatigability' after Epley maneuver and to identify the therapeutic efficacy of Epley maneuver in posterior canal BPPV (PC-BPPV). Subjects and Method This study was prospectively conducted by two dizziness clinics on 51 consecutive patients diagnosed with PC-BPPV. All patients included in the study received Epley maneuver treatment. The therapeutic results were reassessed immediately after a single trial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm the fatigability of diagnostic procedure immediately after treatment. If the treatment was not successful after 30 minutes, Epley maneuver was repeatedly performed until complete resolution. Results Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigo nor nystagmus during the positional test. All patients demonstrated complete resolution after receiving one to three Epley maneuvers on the day of diagnosis. 'Fatigability (false negative result)' was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observed after 30 minutes but not identified immediately after the first Epley maneuver. Conclusion The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Considering the possibility of fatigability when reassessment is performed immediately after therapeutic maneuver, clinicians should avoid assessing the outcome immediately after treatment in patients with PC-BPPV.