Case Report: New Application of a Gufoni Maneuver Variation for Apogeotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

Jiaoxuan Dong, Ling Li, Songbin He, Haipeng Liu, Fangyu Dai

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    Background: Several 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 description: A 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. Conclusion: The 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.
    Original languageEnglish
    Article number902758
    Number of pages5
    JournalFrontiers in Neurology
    Early online date10 Jun 2022
    Publication statusPublished - 10 Jun 2022

    Bibliographical note

    Copyright © 2022 Dong, Li, He, Liu and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the
    original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.


    Funding Information: This study was supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission and the Planned Projects of Bureau of Science and Technology of Zhoushan (2020ZH065 and 2020C31048).


    • Neurology
    • canalith repositioning procedure
    • benign paroxysmal positional vertigo (BPPV)
    • semicircular canals
    • Gufoni maneuver
    • case report
    • apogeotropic variant


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