Journal articles: 'Gufoni maneuver'

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Maranhão, Eliana Teixeira, and Péricles Maranhão Filho. "Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients." Arquivos de Neuro-Psiquiatria 73, no. 6 (2015): 487–92. http://dx.doi.org/10.1590/0004-282x20150040.

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Benign paroxysmal positional vertigo (BPPV), the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%), the barbecue 360° maneuver in twelve patients (32.4%), both manoeuvers in four patients (10.8%), both manoeuvers plus head shaking in one patient (2.7%), and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0%) on the initial visit.

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Alvarez de Linera-Alperi, Marta, Octavio Garaycochea, Diego Calavia, David Terrasa, Nicolas Pérez-Fernández, and Raquel Manrique-Huarte. "Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo: Zuma e Maia Maneuver versus Appiani Variant of Gufoni." Audiology Research 12, no. 3 (2022): 337–46. http://dx.doi.org/10.3390/audiolres12030035.

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Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that causes dizziness. The incidence of horizontal semicircular canal (HSC) BPPV ranges from 5% to 40.5% of the total number of BPPV cases diagnosed. Several studies have focused on establishing methods to treat BPPV caused by the apogeotropic variant of the HSC, namely, the Appiani maneuver (App). In 2016, a new maneuver was proposed: the Zuma e Maia maneuver (ZeM), based on inertia and gravity. The aim of this study is to analyze the efficacy of App versus ZeM in the resolution of episodes of BPPV produced by an affectation of the horizontal semicircular canal with apogeotropic nystagmus (Apo-HSC). A retrospective, quasi-experimental study was conducted. Patients attended in office (November 2014–February 2019) at a third-level hospital and underwent a vestibular otoneurology assessment. Those who were diagnosed with Apo-HSC, treated with App or ZeM, were included. To consider the efficacy of the maneuvers, the presence of symptoms and/or nystagmus at the first follow up was studied. Patients classified as “A” were those with no symptoms, no nystagmus; “A/N+”: no symptoms, nystagmus present during supine roll test; “S”: symptoms present. Previous history of BPPV and/or otic pathology and calcium levels were also compiled. From the 54 patients included, 74% were women. The average age was 69. Mean follow-up: 52.51 days. In those patients without previous history of BPPV (n = 35), the probability of being group “A” was 63% and 56% (p = 0.687) when treated with App and ZeM, respectively, while being “A/N+” was 79% and 87% for App and ZeM (p = 0.508). Of the 19 patients who had previous history of BPPV, 13% and 64% were group “A” when treated with App and ZeM (p = 0.043), and 25% and 82% were “A/N+” after App and ZeM, respectively (p = 0.021). In conclusion, for HSC cupulolithiasis, ZeM is more effective than App in those cases in which there is a history of previous episodes of BPPV (“A”: 64% (p = 0.043); “A/N+”: 82% (p = 0.021)).

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El-Makhzangy, Aly M. Nagy. "Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis." Advances in Otolaryngology 2015 (December 10, 2015): 1–7. http://dx.doi.org/10.1155/2015/465095.

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Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC) follows the posterior semicircular canal (PSCC) as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1–24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic). Level Ia evidence (systematic review of RCTs) shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

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Atsushi, Tamura. "A case of apogeotropic horizontal canal benign paroxysmal positional vertigo (cupulolithiasis) due to head contusion in an adolescent." Archives of Otolaryngology and Rhinology 4, no. 3 (2018): 048–49. https://doi.org/10.17352/2455-1759.000075.

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A 17-year-old high school boy who complained of severe positional vertigo visited our hospital. He belonged to an American football team in high school, and his head often hit opponents during games. The vertigo was strongest when his left ear was down in the supine position. Physical examination and computed tomography revealed no abnormalities. However, positional testing revealed apogeotropic direction-changing horizontal nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Additionally, in the supine position, a null point for horizontal nystagmus was identified, beyond which the nystagmus changed direction. This null point was evident when the head was turned 10 degrees to the side. The diagnosis was right lateral canal type of BPPV caused by cupulolithiasis. He was treated with the Gufoni maneuver and reported a decreased incidence of positional vertigo upon re-evaluation.

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Picciotti, Pasqualina Maria, Giulio Cesare Passali, Bruno Sergi, and Eugenio De Corso. "Benign Paroxysmal Positional Vertigo (BPPV) in COVID-19." Audiology Research 11, no. 3 (2021): 418–22. http://dx.doi.org/10.3390/audiolres11030039.

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Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining of vertigo. Patients were evaluated at the end of infection with an accurate clinical history, and the investigation of spontaneous, positional and positioning nystagmus. Results: The vestibular findings showed benign paroxysmal positional vertigo (BPPV) in all the patients. Three patients had a mild phenotype of the COVID infection, whereas five subjects were hospitalized for the COVID infection and in three cases intensive care was required. Vestibular evaluation showed an involvement of posterior semicircular canals in five patients and horizontal in three. Three patients were treated with the Epley maneuver, two with Semont, one with Lempert and two with Gufoni maneuvers. Conclusions: We hypothesize that BPPV in COVID-19 infections can be relate to drugs, prolonged bed rest and to direct damage by viral infection on the peripheral vestibular system and in particular on the otolitic membrane due to the cytopathic effect of the virus and to the inflammatory response. Studies on large series of patients are needed to confirm our preliminary observation and to better evaluate the pathophysiological mechanisms underlying BPPV in these patients.

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Fu, Wei, Junliang Han, Ning Chang, et al. "Immediate efficacy of Gufoni maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV): a meta-analysis." Auris Nasus Larynx 47, no. 1 (2020): 48–54. http://dx.doi.org/10.1016/j.anl.2019.05.002.

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Mandalà, Marco, Emanuela Pepponi, Giovanni Paolo Santoro, et al. "Double-blind randomized trial on the efficacy of the Gufoni maneuver for treatment of lateral canal BPPV." Laryngoscope 123, no. 7 (2013): 1782–86. http://dx.doi.org/10.1002/lary.23918.

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Dai, Qingqing, Qiurong Chen, Li Yin, Hong Zheng, Shi-Xi Liu, and Maoli Duan. "The long-term follow-up of 61 horizontal canal BPPV after Gufoni and Barbecue maneuver: a prospective study." Acta Oto-Laryngologica 140, no. 6 (2020): 463–66. http://dx.doi.org/10.1080/00016489.2020.1725114.

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Kim, Hyun Ah, Sang-Won Park, Jungil Kim, et al. "Efficacy of mastoid oscillation and the Gufoni maneuver for treating apogeotropic horizontal benign positional vertigo: a randomized controlled study." Journal of Neurology 264, no. 5 (2017): 848–55. http://dx.doi.org/10.1007/s00415-017-8422-2.

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Shi, Tianming, Lihua Yu, Yi Yang, et al. "The effective clinical outcomes of the Gufoni maneuver used to treat 91 vertigo patients with apogeotropic direction-changing positional nystagmus (apo-DCPN)." Medicine 97, no. 39 (2018): e12363. http://dx.doi.org/10.1097/md.0000000000012363.

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Vats, Ajay Kumar. "Unveiling Positioning Nystagmus in Patients of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo by Diagnostic Head-Shaking in the Yaw Plane." Annals of Otology and Neurotology 2, no. 02 (2019): 85–88. http://dx.doi.org/10.1055/s-0039-1695678.

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Abstract Introduction The diagnosis of benign paroxysmal positional vertigo (BPPV) is largely dependent on elicitation of positioning nystagmus on the diagnostic positional tests, namely Dix-Hallpike and supine roll tests (DHT and SRT, respectively), in patients complaining of vertigo, which occurs when patient’s head moves relative to the gravity. The pattern of elicited positioning nystagmus localizes as well as lateralizes the diseased canal, and the therapeutic positioning maneuver is accordingly undertaken. Objective The diagnostic positional tests, at times fail to elicit positional nystagmus, leaving clinician in a state of dilemma, when examining a patient who is currently experiencing paroxysms of vertigo triggered by positional change. In two patients with history consistent with BPPV but with negative positional tests initially, head shaking for 10 seconds in the yaw axis was done, and Dix-Hallpike and supine roll tests were repeated. The aim of head shaking for 10 seconds was to unveil positional nystagmus, to precisely localize and lateralize the diseased semicircular canal. Results and Discussion In the two cases of horizontal semicircular canal BPPV (HSC-BPPV) reported here, the DHT and/or SRT initially failed to elicit positional nystagmus but head shaking for 10 seconds in the left Dix–Hallpike position in case one and with the head anteflexed 30-degrees in the sitting position in the case two, unveiled horizontal positional nystagmus on ensuing SRT. The use of head-shaking in the yaw plane to unveil a horizontal positioning nystagmus in cases where a conventional positional test (DHT and SRT) has failed to elicit the PN, has not been reported in the literature hitherto. Conclusion After precise localization and lateralization of the diseased canal, both patients successfully underwent successful treatment with Gufoni maneuver. A verifying SRT done at 1 hour and/or at 24 hours follow-up was negative. In patients, who are currently experiencing paroxysms of vertigo triggered by the change of position of head relative to the gravity; head-shaking for few seconds just prior to the positioning test, can unveil positional nystagmus not elucidated with the conventionally performed positional tests.

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Lee, Jiyeon, Dong‐Han Lee, Haemin Noh, Jung Eun Shin, and Chang‐Hee Kim. "Immediate and short‐term effects of Gufoni and Appiani liberatory maneuver for treatment of ageotropic horizontal canal benign paroxysmal positional vertigo: A prospective randomized trial." Laryngoscope Investigative Otolaryngology 6, no. 4 (2021): 832–38. http://dx.doi.org/10.1002/lio2.600.

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Fu, Wei, Junliang Han, Ning Chang, et al. "Corrigendum to “Immediate efficacy of Gufoni maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV): A meta-analysis” [Auris Nasus Larynx (2020) 48–54]." Auris Nasus Larynx 47, no. 1 (2020): 171–72. http://dx.doi.org/10.1016/j.anl.2019.07.001.

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Sharma, Kumar Gourav, and Ashok Kumar Gupta. "Effect of barbecue role and Gufoni maneuvers on quality of life in patients with horizontal semicircular canal benign paroxysmal positional vertigo." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 7 (2020): 1311. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20202534.

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Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause in patients with vertigo. Horizontal semi-circular canal BPPV (HSCBPPV) is up to 20% of BPPV. Quality of life (QoL) is significantly impaired by vertigo. Aim of present research was to study the effect and compare barbecue role and Gufoni maneuvers on QoL in patients with HSCBPPV.Methods: 60 individuals with unilateral HSCBPPV were selected. 2 groups barbecue role and Gufoni were formed and 30 individuals were selected in each group randomly. Vestibular activities and participation (VAP) and positional test were administered before and after barbecue role and Gufoni maneuvers to fulfill the aim. Results: VAP scale results revealed significant difference between pre and post treatment score in both groups, suggestive of positive effect on quality of life in patients with HSCBPPV. Improvements in VAP score between both groups were compared and significant difference was observed. Positional test post treatment revealed that 83.33% and 70% patients improved in barbecue role and Gufoni respectively.Conclusions: Barbecue role found to be better than Gufoni in treatment of unilateral HSCBPPV.

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Farnell, L., M. Anderson, D. Savage, and R. Ohle. "P106: The BPPV Tool: designing a smartphone app to aid in the diagnosis of benign paroxysmal positional vertigo." CJEM 22, S1 (2020): S103. http://dx.doi.org/10.1017/cem.2020.312.

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Innovation Concept: Dizziness is an increasingly common presenting complaint in the emergency department (ED), accounting for >2% of visits annually or almost 30% of visits in patients aged over 65. Approximately half of all cases of dizziness in older adults are caused by benign paroxysmal positional vertigo (BPPV). The use of computerized tomography (CT) to rule out serious but rare underlying central nervous system (CNS) causes in patients with dizziness in the ED is increasing despite guidelines supporting the use of clinical exam maneuvers such as the Dix-Hallpike test and therapeutic canalith repositioning maneuvers. Evidence indicates that these clinical tools are underutilized due to clinician discomfort or lack of understanding in performing and interpreting the maneuvers, supporting brief and accessible clinical resources that incorporate video examples to address this. Methods: Through an iterative process the authors have developed a smartphone app that is designed to facilitate the clinical diagnosis of BPPV and provide treatment maneuvers where appropriate. The app is being tested by clinicians practicing emergency medicine or primary care in Northern Ontario. Curriculum, Tool, or Material: The BPPV Tool is designed as a step-wise guide to diagnose BPPV. Clinicians will be prompted to perform specific exam maneuvers based on clinical findings, and can follow short example videos or written directions. Potentially precipitated nystagmus is described along with example videos. Provocative tests include the Dix-Hallpike and Supine Roll. If appropriate, the clinician will be prompted to perform therapeutic repositioning maneuvers such as the Epley or Gufoni, with associated sample videos, descriptions, and billing information where available. If at any point a clinician's exam findings are not in keeping with a diagnosis of BPPV, they will be alerted to this and stop progressing through the app. Conclusion: The BPPV Tool is an accessible and easily disseminated smartphone app designed to improve clinician comfort in reliably diagnosing BPPV. Diagnosing this common condition clinically is supported in the literature and can reduce the number of unnecessary CT scans performed, which would reduce healthcare costs and ED length of stay for these visits, and could reduce the number of patient transfers from peripheral sites for imaging.

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Dong, Jiaoxuan, Ling Li, Songbin He, Haipeng Liu, and Fangyu Dai. "Case Report: New Application of a Gufoni Maneuver Variation for Apogeotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo." Frontiers in Neurology 13 (June 10, 2022). http://dx.doi.org/10.3389/fneur.2022.902758.

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BackgroundSeveral canalith repositioning procedures (CRPs) such as Gufoni maneuver have been proposed to treat the apogeotropic lateral semicircular canal variant of BPPV (LC-BPPV). The reported success rate varied widely in different studies. Research showed that there was a risk of treatment failure due to insufficient repositioning of the debris. So far, there is insufficient evidence to recommend a preferable CRP for apogeotropic LC-BPPV.Case descriptionA 49-year-old woman and a 48-year-old man diagnosed with apogeotropic LC-BPPV relapse were treated with original Gufoni maneuver for apogeotropic variant but no satisfactory result was obtained. A variation of Gufoni maneuver originally proposed for the geotropic variant was applied to detach otoconia toward the utricle or the non-ampullary arm. Apogeotropic nystagmus was successfully transformed into the geotropic variant. The subsequent Gufoni maneuver was successful. On a 64-year-old male with untreated apogeotropic LC-BPPV, we performed the Gufoni maneuver variation and observed a change in nystagmus direction. In all the three cases, no relapse of vertigo was reported after 1 month.ConclusionThe new application of Gufoni maneuver variation may improve the treatment of apogeotropic LC-BPPV. Treatment efficacy and patient-specific optimization such as head rotation angle deserve a large-scale validation and further investigation.

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Vats, Ajay Kumar. "The Clinical Spectrum of Patients of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo Attending an Otoneurology Center in South Rajasthan, India and Their Response to Appropriate Repositioning Maneuvers at a Short-Term Follow-Up." Annals of Otology and Neurotology, August 23, 2020. http://dx.doi.org/10.1055/s-0040-1715533.

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Abstract Introduction This article aims to study the clinical spectrum of 20 consecutive patients diagnosed with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) attending an otoneurology center in Udaipur, Rajasthan, India, over a period of 11 months and their response to appropriate repositioning maneuvers evaluated at short-term follow-up of 1 hour and 24 hours. Study Design This is a nonrandomized prospective interventional study. Materials and Methods Twenty patients with unilateral HSC-BPPV were treated with a session of an appropriate repositioning maneuver (Gufoni maneuver or barbecue roll maneuver for the geotropic variant of HSC-BPPV [geo-HSC-BPPV]; Appiani maneuver or barbecue roll maneuver or head-shaking maneuver for the apogeotropic variant of the HSC-BPPV [apo-HSC-BPPV]). Patients were followed up twice (at 1 hour and 24 hours) and audited by a supine roll test with questioning for the absence or presence of concomitant vertigo. Results At the 1-hour follow-up, 78.57% (11/14) patients of geo-HSC-BPPV treated with Gufoni maneuver recovered, and 66.67% (4/6) patients of apo-HSC-BPPV treated with some form of physical therapy recovered. The recovery was maintained at 24 hours’ follow-up in both groups. Conclusion To the best of the author’s knowledge, no such study on patients of HSC-BPPV has been reported from India hitherto. Gufoni maneuver is an effective and safe treatment for the geo-HSC-BPPV with a recovery rate of 78.57% (11/14) at a short-term follow-up. The physical therapy for the apo-HSC-BPPV must be tailored according to the purported site of pathology which cannot be precisely predetermined most of the times.

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Sangwan (PT), Preeti, Sonia Saroha(PT), and Suman Rani (PT). "EFFICACY OF SEMONT MANEUVER VS GUFONI MANEUVER IN IMPROVING THE QUALITY OF LIFE IN BPPV PATIENTS: A COMPARATIVE STUDY." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, May 1, 2024, 52–55. http://dx.doi.org/10.36106/ijsr/0801949.

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Objective: The aim of study was to nd out the effectiveness of the Epley maneuver, Semont maneuver and Gufoni maneuver on vertigo in BPPV and to evaluate the effectiveness of Epley maneuver and Semont maneuver and gufoni maneuver by using DHI, and ABC scale (Activities- Specic Balance Condence scale). A comparative study, including google scholar, pubMed as data sources. 50 Methodology: patients were included both male and female were included with age group between 50-65 years. Duration of study was 4 weeks and method used for sampling was convenient. The treatment was done using Epley Maneuver and Semont Maneuver (Group A) and Epley and Gufoni Maneuver (Group B). Outcomes were measured using DHI and ABC scale, questionnaires at beginning and at the end of repositioning treatment. Mean result of the DHI of both Result: the groups shows that the post results of the group 2 have more effect than that of the group 1. The post of group 1 was 30.88 whereas the post of the group 2 was 6.96 And More the DHI the more functional disability is present. To become more functionally stable DHI should be lowered. Means result of the ABC of both the groups shows that the post results of the group 2 have more effect than that of the group. The post of the group 1 was 73.06 and post of the group 2 was 81.00 and the more the ABC score the more Functional stability is present. The study concludes that Conclusion: there was marked improvement in functional balance, disability and postural control following Epley maneuver and Gufoni maneuver. Both the group have positive effects and was effective for long term intervention in vertigo patients and these maneuver can be added to the regular intervention for vestibular rehabilitation to decrease the symptoms of the patients.

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Li, Jianxin, Haoxiang Hu, Yihan Zhang, and Xiaokai Yang. "Enhancing the security of horizontal canal BPPV repositioning maneuvers: insights from virtual simulation." Frontiers in Neurology 16 (May 16, 2025). https://doi.org/10.3389/fneur.2025.1560324.

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Horizontal canal benign paroxysmal positional vertigo (hc-BPPV) presents distinct challenges in both diagnosis and treatment. This study aims to explore the trajectories of otoliths during different hc-BPPV reduction maneuvers using advanced virtual simulation technology, and evaluate the theoretical effectiveness and security of these maneuvers while providing recommendations for optimizing current techniques or developing innovative approaches. We created a high-fidelity, three-dimensional (3D) virtual model of the human vestibular system that accurately depicts the horizontal semicircular canal. Utilizing the Unity 3D platform combined with NVIDIA PhysX physics engines, and simulated various hc-BPPV repositioning maneuvers, including the Lempert roll, Gufoni maneuver, forced prolonged positioning, and Zuma maneuvering. The otoliths were modeled as spherical particles, with their motion trajectories analyzed through precise quaternion rotation. Then, we collected and examined the 3D trajectory, velocity, and positional changes of the otoliths in relation to key anatomical landmarks. The simulations indicate that traditional maneuvers such as Lempert and Gufoni are effective in repositioning otoliths, but along with the risk that otoliths mistakenly inserted into other semicircular canals. In contrast, Zuma maneuver is more complex to execute, but it provides higher security. The improved Zuma maneuver not only simplifies the procedure but also maintains high efficacy and security standards. This study provides a comprehensive comparison of various hc-BPPV repositioning maneuvers using virtual simulation technology. The modified Zuma maneuver is proposed as a more effective and safer treatment method. Further clinical validation and individual adjustment studies are necessary to optimize this approach and improve hc-BPPV management strategies.

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Lee, Hyun Jin, Eun-Ju Jeon, Sungil Nam, et al. "Treatment efficacy of various maneuvers for the lateral canal benign paroxysmal positional vertigo with apogeotropic nystagmus – a Randomized controlled trial." Clinical and Experimental Otorhinolaryngology, July 26, 2023. http://dx.doi.org/10.21053/ceo.2023.00619.

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Objectives: To investigate the most effective treatment method by comparing the effects of various otolith reduction techniques in patients with apogeotropic lateral semicircular benign paroxysmal positional vertigo (LC-BPPV).Methods: We performed a multicenter, randomized prospective study between January and December 2015 on 72 consecutive patients with apogeotropic LC-BPPV. The treatment group was divided into three groups: therapeutic head-shaking (THS, Group A), Gufoni-Appiani maneuver (Group B), and cupulolith repositioning maneuver (CuRM) (Group C). Each treatment group was evaluated and treated until the 4th week.

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Strupp, Michael, Nils Lucca Kern, Göran Laurell, Louisa Lehner, Eva Grill, and Ralf Strobl. "World-wide survey on the treatment of peripheral vestibular disorders." Frontiers in Neurology 16 (February 4, 2025). https://doi.org/10.3389/fneur.2025.1540443.

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ObjectiveThe aim of this world-wide survey was to evaluate the currently applied treatment options for the six most frequent peripheral vestibular disorders: benign paroxysmal positional vertigo (BPPV), acute unilateral vestibulopathy (AUVP)/vestibular neuritis, Menière’s disease (MD), bilateral vestibulopathy (BVP), vestibular paroxysmia (VP) and superior canal dehiscence syndrome (SCDS).BackgroundFor the therapy of vestibular disorders, there are four treatment options: vestibular physical therapy (canalith repositioning maneuvers or balance training), pharmacotherapy, surgery, and psychotherapy. Since there are very few state-of-the-art RCTs, the treatment of vestibular disorders is so far not standardized and various methods are applied with heterogeneous efficacy.Design/methodsA web-based standardized survey questionnaire on the treatment of the six most frequent peripheral vestibular disorders was used to collect data.Results234 replies from five continents, 47 countries, 162 cities and 188 centers were received: (% from all 234 replies; multiple answers possible): BPPV: posterior canal BPPV: 71% Epley, 40% Semont, and 12% others. Horizontal canal BPPV canalolithiasis: 58% Lempert (roll-over) maneuver, 33% Gufoni, 7% prolonged rest, and 9% others. Horizontal canal BPPV cupulolithiasis: 35% Gufoni, 27% Lempert (roll-over) maneuver, 9% Zuma, and 7% head shaking: AUVP: 79% pharmacotherapy, namely 47% glucocorticoids, 39% antiemetics, and 24% betahistine; 67% vestibular physical therapy. MD: 85% pharmacotherapy, namely 65% betahistine, 21% diuretics, 20% steroids, 16% antiemetics, 14% gentamicin; 37% surgery. VP: 65% pharmacotherapy, namely 57% anticonvulsants; 7% surgery. BVP: 77% vestibular physical therapy. SCDS: 50% surgery, namely 38.8% canal plugging, 23.3% capping and 15.5% resurfacing.ConclusionIn this world-wide survey with 234 replies from 188 centers, widely heterogeneous applied treatment options were reported for the six most frequent peripheral vestibular disorders. This study shows in particular that certain drugs are often used despite low or very low evidence. Namely in AUVP, MD and VP well-designed controlled trials with clinically meaningful endpoints are needed.

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Maas, Britta D. P. J., Roeland B. van Leeuwen, Sylvia Masius-Olthof, Peter Paul G. van Benthem, and Tjasse D. Bruintjes. "Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic." Frontiers in Neurology 12 (July 19, 2021). http://dx.doi.org/10.3389/fneur.2021.720444.

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Purpose: To determine the effectiveness of our treatment protocol for geotropic and apogeotropic horizontal canal benign paroxysmal positional vertigo (h-BPPV).Methods: We retrospectively evaluated patients with newly diagnosed geotropic and apogeotropic h-BPPV who visited our clinic between July 2017 and December 2019. Patients were treated according to our treatment protocol, which was implemented in 2017. Patients with geotropic h-BPPV were preferably treated with the Gufoni maneuver. In patients with apogeotropic h-BPPV we executed the modified Gufoni maneuver to achieve conversion to the geotropic type. We looked at the number of successful treatments and the number of recurrences within 1 year.Results: We included 102 patients with h-BPPV, 62 (61%) of whom were treated for geotropic h-BPPV. The ratio of apogeotropic to geotropic h-BPPV was 0.65. After the first visit, we observed resolution of horizontal canal BPPV in 71 and 63% of the geotropic and the apogeotropic group, respectively. After the second visit, this percentage increased to 92% for geotropic h-BPPV and 78% for apogeotropic h-BPPV. After 1 year of follow-up we determined a recurrence rate of 32 and 24% for the geotropic and apogeotropic group, respectively.Conclusion: With our treatment protocol we managed to achieve high rates of symptom resolution in the geotropic and apogeotropic type of h-BPPV with acceptable recurrence rates. We observed a relatively high ratio of apogeotropic h-BPPV to geotropic h-BPPV.

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Spiegelberg, Maritta, Joao Lemos, Sun-Uk Lee, Jeong-Yoon Choi, and Alexander Andrea Tarnutzer. "Transient Response to Liberation Maneuvers in Central Positional Nystagmus Due to Cerebral Metastases Mimicking Benign Paroxysmal Positional Vertigo– A Case Report." Cerebellum 24, no. 4 (2025). https://doi.org/10.1007/s12311-025-01851-w.

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Abstract Background Benign paroxysmal positional vertigo (BPPV) is by far the most frequent cause of positional nystagmus (PN). However, PN may also be encountered in central lesions. In this case report we describe a patient with isolated positional vertigo and central PN which mimicked a lateral-canal cupulithiasis, including initial response to liberation maneuvers. Case Description A 44-year-old male patient reported new-onset position-dependent vertigo with nausea and gait-imbalance for 10 days. During supine roll testing for the lateral semicircular canals, he showed a persistent apogeotropic PN (being more intense left-ear-down) accompanied by moderate vertigo. Except for the PN, the neurologic examination was normal. He received a diagnosis of a apogeotropic-variant right-lateral canal BPPV and responded well to a Gufoni maneuver (nose-up). However, on follow-up, apogeotropic PN showed-up again, converted into a geotropic variant after a Barbecue-liberation maneuver, and then disappeared. Due to the re-emergence of the initial PN on the second follow-up consult, a brain-MRI was requested, disclosing disseminated infra- and supratentorial cystic brain metastases. The largest mass compressed midline cerebellar structures. Urgent surgical resection revealed a histopathologic diagnosis of an adeno-carcinoma of the lung. Discussion Short-lasting responses to liberation maneuvers may also be seen in CPN, mimicking the response-pattern expected in BPPV cases. Thus, response to treatment must be validated on a follow-up consultation. Pressure by a cystic cerebellar mass lesion on the nodulus and uvula that varies with changing head-position relative to gravity, resulting in adaptational changes in PN direction and intensity could explain our findings.

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Alashram, Anas R. "Gufoni maneuver for treatment of horizontal canal benign paroxysmal positional vertigo: a systematic review of randomized controlled trials." European Archives of Oto-Rhino-Laryngology, May 5, 2024. http://dx.doi.org/10.1007/s00405-024-08712-y.

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Vats, Ajay Kumar. "A case of apogeotropic horizontal canal benign paroxysmal positional vertigo that transformed to the geotropic variant during treatment with Appiani maneuver, followed by successful treatment with Gufoni maneuver." Physiotherapy Theory and Practice, August 12, 2020, 1–9. http://dx.doi.org/10.1080/09593985.2020.1805831.

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Journal articles on the topic 'Gufoni maneuver'

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