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Apogeotrophic Nystagmus

 

If apogeotrophic (beating towards the sky) nystagmus presents with the roll test, the side with less intense nystagmus and symptoms is most likely involved (G. Asprella Libonati, 2005; Galgon, 2012; Shubert 2012).  









As of 2008, the evidence did not seem to support one course of treatment over another (Bhattacharyya et al., 2008).  However, in a double blind randomized control study evaluating the effectiveness of the Gufoni maneuver for both variants of BPPV, Mandala et al., 2013 highly recommends the Gufoni for treatment of apotrophic variant of BPPV.

In a prospective study conducted by Boleas-Aguirre, Perez, & Batuecas-Caletrio, 2009, forced prolonged positioning for two weeks may be effective for the management of apogeotrophic variant of BPPV.  

Minimal evidence supports these approaches

Text book recommendation according to Herdman, S. J., 2007

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