Benign paroxysmal positional vertigo with multiple canal involvement

Am J Otolaryngol. Mar-Apr 2012;33(2):250-8. doi: 10.1016/j.amjoto.2011.07.007. Epub 2011 Sep 13.


Purpose: The aims of this study were to describe the frequency and clinical features of benign paroxysmal positional vertigo (BPPV) with multiple canal involvement and to evaluate the results of treatment by appropriate canalith repositioning procedures.

Materials and methods: A total of 345 patients were referred for BPPV between 2006 and 2010. Thirty-two of them (9.3%) who had BPPV of multiple canals were studied. Thirteen were men (mean age, 60.4 years) and 19 were women (mean age, 56.8 years). Dix-Hallpike and supine roll tests were performed for diagnosis. Canalith repositioning procedures for treatment included modified Epley, barbecue, Gufoni, and anterior BPPV-specific maneuvers.

Results: Twenty-one patients had bilateral posterior canal BPPV, and 11 had mixed canal BPPV either on the same side (7 patients) or on both sides (4 patients). Thirty-one patients were cured with an average of 2.9 therapeutic sessions per patient. Recurrences occurred in 5 patients (15.6%).

Conclusions: Benign paroxysmal positional vertigo of multiple canals is not rare and presents a clinical challenge. However, accurate diagnosis results in successful treatment comparable with BPPV of 1 canal.

Publication types

  • Comparative Study

MeSH terms

  • Audiometry, Pure-Tone
  • Benign Paroxysmal Positional Vertigo
  • Electronystagmography
  • Evoked Potentials, Auditory, Brain Stem
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Greece / epidemiology
  • Humans
  • Immobilization / methods*
  • Incidence
  • Male
  • Middle Aged
  • Patient Positioning / methods*
  • Posture / physiology*
  • Prognosis
  • Retrospective Studies
  • Semicircular Canals / physiopathology*
  • Vertigo / diagnosis
  • Vertigo / epidemiology*
  • Vertigo / therapy