Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo Presenting with Torsional Downbeating Nystagmus: An Apogeotropic Variant

Table 1

Evolution of pathological signs in selected patients, during the period of observation and treatment. DH: Dix-Hallpike; HHP: head hanging position; SLP: side lateral position; CCW: conterclockwise; CW: clockwise; UB: upbeating; DB: downbeating; PC: posterior semicircular canal; AC: anterior semicircular canal; SC: semicircular canal.

(a)  

	First checkup
Patient	Provoking manoeuvre(s)	PPNy	Reversal of PPNy	SC; hypothesized	Therapy
1	Right DH-left DH-HHP-; right SLP-left SLP	CW-DB	Absent	Left AC	“Reversed” Epley’s; manoeuvre
2	Right DH-left DH-HHP-; right SLP-left SLP	CW-DB	Absent	Left AC	“Reversed” Epley’s; manoeuvre
3	Left DH	CW-DB	Absent	Left AC	“Reversed” Epley’s; manoeuvre
4	Right DH-left DH	CW-DB	Absent	Left AC	Vannucchi’s manoeuvre
5	Right DH-left DH	CW-DB	Absent	Left AC	Vannucchi’s manoeuvre
6	Right DH-HHP	CCW-DB	CW-UB	Right AC	“Reversed” Epley’s; manoeuvre

(b)  

	After 30 minutes			Second check-up
Patient	PPNy	SC; hypothesized	Therapy	PPNy	SC; hypothesized	Therapy
1	CCW-UB	Right PC	Semont’s; manoeuvre	Absent	—	—
2	CCW-UB	Right PC	Semont’s; manoeuvre	Absent	—	—
3	CW-DB	Left AC	“Reversed” Epley’s; manoeuvre	CW-DB	Left AC	“Reversed” Epley’s; manoeuvre
4	CCW-UB	Right PC	Semont’s; manoeuvre	Absent	—	—
5	CW-DB	Left AC	Vannucchi’s; manoeuvre	CCW-UB	Right PC	Semont’s; manoeuvre
6	CW-UB	Left PC	Semont’s; manoeuvre	Absent	—	—

(c)  

	Third check-up			Fourth check-up
Patient	PPNy	SC; hypothesized	Therapy	PPNy	SC; hypothesized	Therapy
1	—	—	—	—	—	—
2	—	—	—	—	—	—
3	CCW-UB	Right PC	Semont’s; manoeuvre	Absent	—	—
4	—	—	—	—	—	—
5	Absent	—	—	—	—	—
6	—	—	—	—	—	—