Sauvage J P, Aubry K, Codron S
CHU Dupuytren, Service ORL, 2 rue Martin Luther King, F-87000 Limoges, France.
Rev Laryngol Otol Rhinol (Bord). 2005;126(4):257-62.
The incidence of benign paroxysmal positional vertigo (BPPV) of the horizontal and superior semicircular canals is much less than that of BPPV due to affection of the posterior semicircular canal. Their diagnosis is however much more difficult and still prone to controversies. The provocative manoeuvre of the BPPV of the horizontal canal (BPPV-HSC) is the manoeuvre of rotation of the head in dorsal position. A horizontal positional nystagmus is obtained. There are two forms of BPPV-HSC: the geotropic form and the ageotropic form. In the geotropic form, the liberatory manoeuvre is a "barbecue" rotation of 180 with 360 degrees towards the healthy side. In the ageotropic form, there is no universal liberatory manoeuvre. Moreover as some cases of neurological aetiology have been recognized, it is not appropriate to apply ineffective manoeuvres. The BPPV of the superior canal (BPV-SSC) is very rare. The provocative manoeuvre is the Dix and Hallpike's manoeuvre. It causes positional torsional and vertical nystagmus with an opposite direction to that obtained for a BPPV of the contra-lateral posterior canal. The liberatory manoeuvre is a Semont manoeuvre, which is identical to that we would make for a contra-lateral BPPV of the posterior canal.
水平半规管和上半规管良性阵发性位置性眩晕（BPPV）的发病率远低于后半规管受累引起的BPPV。然而，它们的诊断要困难得多，且仍然容易引发争议。水平半规管BPPV（BPPV-HSC）的激发试验是在仰卧位时头部旋转试验。可诱发出水平位置性眼震。BPPV-HSC有两种类型：地向性型和背地性型。在地向性型中，复位试验是向患侧进行180°至360°的“烧烤”旋转。在背地性型中，没有通用的复位试验。此外，由于已认识到一些神经病因的病例，应用无效的试验是不合适的。上半规管BPPV（BPV-SSC）非常罕见。激发试验是Dix和Hallpike试验。它会引起位置性扭转性和垂直性眼震，其方向与对侧后半规管BPPV所诱发的眼震方向相反。复位试验是Semont试验，这与我们对后半规管对侧BPPV所做的试验相同。
