Hiroaki Ichijo1. 1. a Department of Otolaryngology , Ichijo Ear, Nose and Throat Clinic , Hirosaki , Japan.
Abstract
CONCLUSION: Benign paroxysmal positional vertigo (BPPV) is strongly related to sleep. This study proposes a micro-otoconia accumulation theory in which the pathological debris is an aggregate of micro-otoconia over a long time period, and which begins to slide by its own weight during sleep. OBJECTIVES: To examine the onset time of idiopathic BPPV and to investigate its etiology. METHOD: Patients (n = 351) were classified as posterior canalolithiasis (PC), horizontal canalolithiasis (HC), and horizontal heavy cupula (HHC) according to nystagmus findings. This study examined the medical records, and categorized the onset times into the following four groups; (1) during sleep, (2) at the time of rising, (3) morning, and (4) afternoon. RESULTS: PC (n = 135): In 33 patients, vertigo occurred during sleep, in 69 patients at rising, in 10 patients in the morning, and in 23 patients in the afternoon. HC (n = 87): In 38 patients, vertigo occurred during sleep, in 30 patients at rising, in eight patients in the morning, and in 11 patients in the afternoon. HHC (n = 129): In 27 patients, vertigo occurred during sleep, in 59 patients at rising, in 15 patients in the morning, and in 28 patients in the afternoon.
CONCLUSION:Benign paroxysmal positional vertigo (BPPV) is strongly related to sleep. This study proposes a micro-otoconia accumulation theory in which the pathological debris is an aggregate of micro-otoconia over a long time period, and which begins to slide by its own weight during sleep. OBJECTIVES: To examine the onset time of idiopathic BPPV and to investigate its etiology. METHOD:Patients (n = 351) were classified as posterior canalolithiasis (PC), horizontal canalolithiasis (HC), and horizontal heavy cupula (HHC) according to nystagmus findings. This study examined the medical records, and categorized the onset times into the following four groups; (1) during sleep, (2) at the time of rising, (3) morning, and (4) afternoon. RESULTS: PC (n = 135): In 33 patients, vertigo occurred during sleep, in 69 patients at rising, in 10 patients in the morning, and in 23 patients in the afternoon. HC (n = 87): In 38 patients, vertigo occurred during sleep, in 30 patients at rising, in eight patients in the morning, and in 11 patients in the afternoon. HHC (n = 129): In 27 patients, vertigo occurred during sleep, in 59 patients at rising, in 15 patients in the morning, and in 28 patients in the afternoon.