AN OVERLOOKED CLİNİCAL CONDİTİON:MULTİ-CANAL BENİGN PAROXYSMAL POSİTİONAL VERTİGO

Prof. Dr. Turhan San*

Objective
Benign paroxysmal positional vertigo (BPPV), which is most common peripheral vestibular disorder caused by changes in head position relative to the direction of gravity, characterized by recurrent temporary dizziness and characteristic nystagmus. BPPV is self-limiting and recurrent. It is generally believed that BPPV arises from otoliths that separate from the utricular macula, fall into the semicircular canals, or attach to the cupula, resulting in a range of signs and symptoms. The Bárány Society International Classification Committee of Vestibular Disorders published an expert consensus paper on BPPV diagnostic criteria in 2015 in the Journal of Vestibular Research.[1] BPPV most often involves a single semicircular canal and posterior canal (PC) is the most frequently affected canal, accounting for 70-90% of all BPPV cases[2], this is followed by the horizontal canal (HC) which accounts for 10%-30% of all cases[3], and the anterior canal (AC) accounting for only 1%–2% of all cases[4], respectively. Multi-canal benign paroxysmal positional vertigo (MC-BPPV) is considered to be a rare and controversial type in the new diagnostic guidelines of Bárány because the nystagmus is more complicated or atypical. For this reason, MC-BPPV often remains a diagnostic challenge for the clinician. This is both due to the complex anatomy of the labyrinth and to the complex and often simultaneous ocular responses resulting from stimulation of multiple. Diagnosis was made by Dix- Hallpike test (DH-T) and Roll test (RT). Treatment was performed with the Semont, Epley, Lempert and Yacovino reposition maneuvers according to the affected canals. In this study, we aimed to invastigate the clinical features, diagnosis, and treatment of patients with MC-BPPV and to contribute to the literature.