Clinical features of benign paroxysmal positional vertigo (original) (raw)
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Benign paroxysmal positional vertigo: a multi-center study
The Egyptian Journal of Otolaryngology
Background Benign paroxysmal positional vertigo (BPPV) is the most frequent vestibular disorder with significant morbidity, psychosocial impact, and medical costs. This multi-center study work aimed to review BPPV clinical features, treatment, and outcomes. Methods After a detailed history, clinical examination, audiological assessment, and position provocation tests to diagnose BPPV type, the suitable repositioning maneuver was done. BPPV was diagnosed according to the criteria developed for this study through piloting and validation in a specialized dizziness clinic. The main outcome measures were patient demographics, comorbidities, canal involvement, response to treatment, and incidence of recurrence. Results Within included 114 patients, the affected canal was 93% posterior semicircular canal, 3.5% horizontal semicircular canal, and 3.5% anterior semicircular canal. The response after repositioning maneuver was (86%) after one session and 100% after the second session. Conclusi...
Benign paroxysmal positional vertigo: a clinician's perspective.
ANNALS NEW YORK ACADEMY OF SCIENCES, 2001
The pathogenesis and epidemiology of benign paroxysmal position- al vertigo are still not well defined. Treatment protocols have emerged along with complementary hypotheses regarding pathogenesis. Ultrastructural stud- ies suggest a multistep process of otoconia metabolism responsible for forming the otolith membrane. A defect in otoconia metabolism leads to an excess of otoconia within the utricular sac (utriculolithiasis). Gravitational forces cause the entrapment of otoconia within the semicircular canal system (canalolithia- sis). Localization of these otoconia within the semicircular canal system is de- ducted by combining the gravitational orientation of the canal involved with the vestibular neurophysiology of the resulting nystagmus recorded during testing and throughout treatment. New terminology is required to differentiate short-arm from long-arm canalolithiasis. Evidence from digital videonystag- mography recordings of nystagmus is coupled with principles of gravitational fluid mechanics to explain the mechanisms of disease development and treat- ment. These observations lead to important questions that define future direc- tions in research.
Comparison of Treatment Results for Clinical Types of Benign Paroxysmal Positional Vertigo
Central Asian Journal of Medical Sciences
Objective: To compare the clinical characteristics and treatment results of different clinical types of benign paroxysmal positional vertigo (BPPV). Methods: A total of 162 patients diagnosed with BPPV between January 2019 to January 2021 at EMJJ ENT Hospital’s vestibular laboratory in Mongolia were included in our study. The diagnosis of BPPV was made according to the 2017 AAO-HNS clinical practice guideline for BPPV. Clinical questionnaires, Dizziness Handicap Inventory (DHI) questionnaires, and videonystgamography were obtained for all patients. Results: From a total of 162 patients diagnosed as BPPV, 62.4% had posterior canal BPPV, 27.1% had horizontal canal BPPV, and 10.5% had anterior canal BPPV. Fischer’s exact test showed a higher incidence on the right side (p = 0.000). The mean age 50 ± 11.7; the male to female ratio 1:4. When the relationship between the effectiveness and duration of the treatment was assessed, 123 (75.9%) recovered after 7 days. DHI score after treatment...
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2003
Between 1995 and 2001, eight Italian clinical centres used the same diagnostic and therapeutic protocol in order to assess the clinical progress of paroxysmal positional vertigo and the benefits of an appropriate follow-up in prevention of relapse. The study population comprises 794 patients affected by paroxysmal positional vertigo. The study protocol comprised diagnostic staging including a complete otoneurological test, an anamnestic questionnaire aimed at identifying any possible risk factor, a blood test in basal conditions and monitoring of blood pressure. If necessary, more specific instrumental tests have been carried out. Appropriate rehabilitative manoeuvres were performed from 1 to 3 times within the same session. The patient was checked 3-5 days later: in the presence of a positive result, the treatment was repeated; if negative, patients were seen at clinical follow-up 7, 30, 180 and 365 days after recovery. Wherever possible, patients have been contacted 2 years after ...
Acta Otorrinolaringologica (English Edition), 2008
There are many different vertigo classifications and different denominations are frequently used for the same clinical processes. The Otoneurology Committee of the Spanish Society for Otorhinolaryngology and Head and Neck Pathology proposes an eminently practical classification of peripheral vertigo to facilitate a common terminology that can be easily used by general ENT practitioners. The methodology used has been by consensus within our society and especially among the most outstanding work groups in the area of otoneurology in Spain. Initially vertigo is divided into single-episode vertigo and recurring attacks of vertigo, and these are then sub-divided into 2 groups, depending on whether or not hearing loss is present. Acute vertigo without hearing loss corresponds to vestibular neuritis and if it is associated with hearing loss, it is due to labyrinthitis of different aetiologies and cochleovestibular neuritis. Recurrent vertigos without hearing loss are classified as induced, either by posture (BPPV) or pressure (perilymphatic fistula), or as spontaneous, including migraine-associated vertigo, metabolic vertigo, childhood paroxysmal vertigo, and vertigo of vascular causes (TIAs, vertebrobasilar insufficiency). Finally, recurrent vertigo with hearing loss includes Ménière's disease and others such as vertigomigraine (with hearing loss), autoimmune pathology of the inner ear, syphilitic infection, and perilymphatic fistula (with hearing loss).
Benign Paroxysmal Positional Vertigo
Annals of the New York Academy of Sciences, 2006
The pathogenesis and epidemiology of benign paroxysmal positional vertigo are still not well defined. Treatment protocols have emerged along with complementary hypotheses regarding pathogenesis. Ultrastructural studies suggest a multistep process of otoconia metabolism responsible for forming the otolith membrane. A defect in otoconia metabolism leads to an excess of otoconia within the utricular sac (utriculolithiasis). Gravitational forces cause the entrapment of otoconia within the semicircular canal system (canalolithiasis). Localization of these otoconia within the semicircular canal system is deducted by combining the gravitational orientation of the canal involved with the vestibular neurophysiology of the resulting nystagmus recorded during testing and throughout treatment. New terminology is required to differentiate short-arm from long-arm canalolithiasis. Evidence from digital videonystagmography recordings of nystagmus is coupled with principles of gravitational fluid mechanics to explain the mechanisms of disease development and treatment. These observations lead to important questions that define future directions in research.
Benign Paroxysmal Positional Vertigo: comparison of two recent international guidelines
2011
Beni gn paroxysmal positional Vertigo (BppV) is characterized by vertigo, lasting for a few seconds and usually managed by head positioning maneuvers. To educate clinicians concerning the state-ofthe art knowledge about its management, the international societies developed guidelines. Aim: the aim of this paper is to discuss, in a practical fashion, the current options available to manage BppV. Method: Study design: non-systematic review. This study reviews two recent guidelines regarding the evaluation and treatment of BppV. The first one was published by the American Academy of Otolaryngology Head and neck surgery (AAO-HnS) and the other by the American Academy of neurology (AAn). The similarities were presented in different tables. Results: Those guidelines presented differences regarding methods. Only the AAO-HnS guidelines recommend the dix-Hallpike test for the diagnosis of BppV. Only canalith repositioning maneuver, Semont maneuver and vestibular rehabilitation had showed some benefit and were recommended as good treatment options. Conclusions: Both guidelines fulfilled all the aspects required for clinicians to diagnosed and manage BppV; only the AAO-HnS's guidelines were more comprehensive and of better quality.
Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review
Journal of Clinical Medicine
Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular dysfunctions encountered in clinical practice. Although the treatment of BPPV is relatively successful, many patients develop recurrence after treatment. Our purpose is to evaluate the mean recurrence rate and risk factors of BPPV after treatment. A review of the literature on the risk factors of BPPV recurrence was performed. A thorough search was conducted using electronic databases, namely Pubmed, CINAHL, Academic Search Complete and Scopus for studies published from 2000 to 2020. Thirty studies were included in this review with 13,358 participants. The recurrence rate of BPPV ranged from 13.7% to 48% for studies with follow-up <1 year, and from 13.3% to 65% for studies with follow-up ≥2 years. Pathophysiologic mechanisms and implication of each of the following risk factors in the recurrence of BPPV were described: advanced age, female gender, Meniere’s disease, trauma, osteopenia or o...
Benign Paroxysmal Positional Vertigo: Our Experience
Indian Journal of Otolaryngology and Head & Neck Surgery, 2014
Benign paroxysmal positional vertigo (BPPV) is probably common cause of vertigo. A total of 205 cases reported to ENT OPD for vertigo. Of these 43 patients were found to suffer from BPPV and in our experience BPPV is common condition. BPPV was more common in age group of 4th and 7th decades. The youngest patient reported was 41 years and the oldest patient was 78 years with a mean of 56.5. In this group there were 16 females and 27 males. This is a retrospective case study of 205 cases presenting with vertigo. The modality of treatment was Epley's manoeuvre in cases diagnosed with BPPV. The age of patients ranged from 41 to 78 years with mean of 56.5. The over all success rate was 96 %. All cases were instructed to report recurrence and were followed for 1 year.
Variables Affecting Treatment in Benign Paroxysmal Positional Vertigo
The Laryngoscope, 2000
Objective To identify variables affecting outcome in patients with benign paro‐ysmal positional vertigo (BPPV) treated with canalith repositioning maneuvers.Study Design Retrospective review of patients at a tertiary vestibular rehabilitation center.Methods Variables identified for statistical analysis included method of diagnosis, age, se‐, onset association with trauma, semicircular canal involvement, presence of bilateral disease, treatment visits, and cycles of canalith repositioning maneuvers per treatment visit. Multivariate statistical analysis using Pearson χ2, likelihood ratio, linear‐by‐linear association, and cross‐tabulation tests were performed.Results Two hundred fifty‐nine patients with BPPV who received treatment were identified from 1996 to 1998. Average follow‐up time was 16.9 months. 74.8% required one treatment visit, 19.0% required a second treatment visit, and 98.4% were successfully treated after three treatment visits. The remainder required up to seven treat...