Apogeotropic Posterior Semicircular Canal BPPV—A Case Series from South Rajasthan

Abstract

Apogeotropic variant of posterior semicircular canal benign paroxysmal positional vertigo (apo-PSC-BPPV) is a rare peripheral vestibular disorder, characterized by paroxysms of positionally triggered dizzy spells associated with non-positional disequilibrium. It is diagnosed by observing characteristic diagnostic oculomotor responses (torsional downbeating positional nystagmus) during positional testing (Dix-Hallpike and enhanced straight head hanging tests), in conjunction with a response to physical therapy. Much rarer anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV) elicits identical oculomotor responses during positional testing. Propter hoc, response to physical therapy at short-term follow-up is crucial in distinguishing the apo-PSC-BPPV from ASC-BPPV. We are presenting a case series of seven patients of apo-PSC-BPPV (of which three were bilaterally affected), who attended our otoneurology center, between February 1, 2023, and July 31, 2023. Demographic profile, clinical course, and physical therapy with responses at short-term follow-up at 1 hour and after 24 hours are discussed.