Lateral semicircular canal benign paroxysmal positional vertigo

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the commonest etiologies for vertigo. The most common semicircular canal affected in the pathogenesis of BPPV is the posterior semicircular canal. However, lateral and anterior semicircular canals are also involved in BPPV, but their involvement in etiopathogenesis is still underrated. The pathophysiology for lateral canal BPPV (LC-BPPV) is attributed to otoconia present in the canal, either floating in the semicircular canal or adherent to the cupula. There are two types of LC-BPPV such as geotropic and apogeotropic/ageotropic. Till today, the role of the lateral semicircular canal (LSC) in BPPV is still the most debatable and grey area of the research niche. The geotropic type LC-BPPV is related to canalithiasis of freely mobile otoconia in the nonampullary arm of the LSC. Apogeotropic LC-BPPV is caused by canalithiasis in the ampullary arm or cupulolithiasis with otolithic debris located in the canal or utricular side of the LSC. The pathological side must be identified for successful treatment. The affected side is usually indicated by nystagmus intensity: The more intense positional nystagmus beats toward the affected ear. The identification of the affected ear is very crucial for the successful treatment of the LC-BPPV by using particle repositioning maneuvers. This review article discusses the epidemiology, etiopathology, clinical manifestations, diagnosis, and treatment of LC-BPPV in the pediatric age group.