Daily Exercise Does Not Prevent Recurrence of Benign Paroxysmal Positional Vertigo (original) (raw)
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Strategies to Prevent Recurrence of Benign Paroxysmal Positional Vertigo
Archives of Otolaryngology-head & Neck Surgery, 2005
To determine if a daily routine of Brandt-Daroff exercises increases the time to recurrence and reduces the rate of recurrence of benign paroxysmal positional vertigo (BPPV). Design: Random sample of convenience and retrospective case review. Setting: Tertiary referral center and outpatient clinic. Patients: One hundred sixteen patients diagnosed with BPPV involving the posterior semicircular canal (BPPV-PC) who were successfully treated with the canalith repositioning procedure. Interventions: Patients in the treatment group (n=43) performed daily Brandt-Daroff exercises, while patients in the no-treatment group (n = 73) performed no exercises. Main Outcome Measures: Follow-up was as long as 2 years. Every 2 months patients were mailed a questionnaire. If BPPV had recurred, patients contacted the principal investigator within 24 hours. Within 1 to 2 weeks, patients were evaluated in the clinic with the Dix-Hallpike maneuver or, if unable to travel to the clinic, interviewed by telephone. Results: Symptoms recurred in 50 (43%) of the 116 subjects, 34 (47%) of 73 in the no-treatment group and 16 (37%) of 43 in the treatment group. There was no significant difference in the frequency of recurrence (Pearson 2 , P=.33) or time to recurrence (survival analysis, log-rank test, P=.92). A history of recurrent BPPV-PC did not affect frequency of recurrence (Pearson 2 , P=.33) or time to recurrence (survival analysis, log-rank test, P=.72). Conclusion: Our results suggest that a daily routine of Brandt-Daroff exercises does not significantly affect the time to recurrence or the rate of recurrence of BPPV-PC.
Canalith Repositioning Procedures among 965 Patients with Benign Paroxysmal Positional Vertigo
Audiology and Neurotology, 2013
symptom recurrence was noted in 139 patients. A statistically significantly higher recurrence rate was noted in elderly people or those with head trauma or a history of vestibular neuropathy (p ! 0.001). Conclusions: This study provides class IV evidence that CRP remains an efficient and long-lasting noninvasive treatment for BPPV, especially for younger patients without a history of head trauma or vestibular neuropathy. Elderly people have a significantly higher recurrence rate requiring additional education to minimize potential morbidity of their falls.
Journal of neurology, 2015
This retrospective study was conducted to determine the relationship between variable factors and the recurrence rate of post-semicircular canal benign paroxysmal positional vertigo (PSC-BPPV) after canalith repositioning procedure (CRP). Patients with PSC-BPPV were diagnosed by history and the presence of a positive Dix-Hallpike maneuver between 2008 and 2010. In total, 243 patients (47 males and 196 females, average age = 57.5 years) treated with Epley's maneuver or canalith repositioning procedure (CRP) were included in the study. The demographic factors studied were age, sex, sleep disorders, inner ear diseases, head trauma history, and cardiovascular diseases. Multivariate statistics using SPSS version 15, Pearson's Chi-squared test (χ (2)), Kaplan-Meier analysis, log-rank test, and Cox proportional hazards regression model were used for the analysis. The success rate of vertigo control after the initial CRP was 83.1 %. Pearson's χ (2) test results showed that femal...
Why do Treatment Failure and Recurrences of Benign Paroxysmal Positional Vertigo Occur?
Otology & Neurotology, 2014
Objective: To investigate the potential risk factors associated to the treatment failure and recurrence of benign paroxysmal positional vertigo (BPPV). Study Design: Prospective cohort study. Setting: Tertiary referral center. Patients: Four hundred patients with benign paroxysmal positional vertigo, 119 men and 281 women, aged 27 to 88 years. Intervention: Patients were treated once a week, with only one, appropriate, depending on the affected canal, repositioning maneuver (modified Epley, Semont, barbecue/inverted Gufoni, Kim). The control Dix-Hallpike test and the roll test were performed on 7 days. Main Outcome Measures: The treatment outcome and recurrence were evaluated with regard to sex, age, duration of symptoms, etiologic factors, migraines, osteoporosis, vascular risk factors, endocrine diseases, localization of otoconia, and simultaneous involvement of multiple canals. Results: The results indicate that treatment was negatively affected by patients' age, osteoporosis, and head trauma, without them causing recurrent symptoms. The highest number of uncured patients was observed in the 73-to 88-year-old age group (14.8%). The application of more than one maneuver was necessary in 27.5% of cases with primary BPPV and 88.9% with secondary BPPV. The highest treatment success was achieved in the group with BPPV of the posterior semicircular canal (F = 3.668, p = 0.026). The recurrence rate was 15.5%. Conclusion: Potential risk factors associated to the treatment failure were as follows: the age older than 50, secondary BPPV, head trauma, the occurrence of osteoporosis, and localization of otoconia in the anterior semicircular canal. The analyzed factors did not have impact on the recurrence.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2017
To define the risk factors and adverse effects associated with repeated canalith repositioning procedures (CRPs). A case series featuring chart review. An academic university hospital. We retrospectively reviewed 1900 patients (average age, 54.9 years; range, 11-88 years) diagnosed with benign paroxysmal positional vertigo (BPPV). All underwent repeated CRPs. We recorded clinical features including age, gender, BPPV cause (idiopathic or secondary), symptom duration, the canal involved, the number of sessions of CRP, recurrence, follow-up duration, and complications. We compared these factors using Pearson's chi-squared test and multiple linear regression analysis with dummy variables. BPPV was diagnosed based on the results of the head roll and Dix-Hallpike tests. The overall BPPV resolution rate for patients treated with repeated CRPs was 96.4%. The risk factors for the need for multiple CRPs in BPPV were the duration of vertigo before treatment (β = 0.326, p < 0.001), the t...
Home particle repositioning maneuver to prevent the recurrence of posterior canal BPPV
Auris Nasus Larynx, 2018
To check the value of home particle repositioning maneuver in the prevention of the recurrence of posterior canal benign paroxysmal positional vertigo (pc-BPPV). Methods: In this study, patients diagnosed as unilateral posterior canal BPPV were selected following an accurate evaluation using video goggle VNG system. All patients were managed by particle repositioning maneuver (PRM). Patients were instructed to do home PRM once weekly for five years. Then, they were divided into two groups (according to choice of patient to do PRM). The first group (control group) consisted of 144 patients who did not do home PRM; whereas the second group (study group) included 165 patients who performed home PRM. All patients (control & study groups) were followed up every four months for five years. Results: The study found out that the recurrence rate of pc-BPPV in control group was 33 patients in the first year (27.2%), 11 patients in second year (9%), 5 patients in third year (4%), 3 patients in fourth year (2.5%) and 3 patients in fifth year (2.5%). The recurrence of pc-BPPV in the treated side (study group) of patients was reported as 5 patients in the first year (3.5%), 3 patients in the second year (2%), 2 patients in the third year (1.4%), 2 patients in the fourth year (1.4%), and 1 patient in the fifth year (0.7%). There was statistically significant difference between the control and the study groups regarding the recurrence rates in the first year follow up which was the highest in first four months. Conclusion: Home particle repositioning maneuver has the capacity to prevent the recurrence of pc-BPPV. It proved to be more successful and functional in minimizing the recurrence of the disease in the study than in the control group. Hence, home particle repositioning maneuver is highly recommended for one year at least in pc-BPPV.
International Journal of Environmental Research and Public Health
Objective: Residual dizziness is a disorder of unknown pathophysiology, which may occur after repositioning procedures for benign paroxysmal positional vertigo. This study evaluates the relationship between regular daily physical activity and the development of residual dizziness after treatment for benign paroxysmal positional vertigo. Study Design: Prospective observational cohort study. Setting: Academic university hospital. Methods: Seventy-one patients admitted with benign paroxysmal positional vertigo involving the posterior semicircular canal were managed with Epley’s procedure. Three days after successful treatment, the patients underwent a telephone interview to investigate vertigo relapse. If the patients no longer complained of vertigo, they were asked about symptoms consistent with residual dizziness. Subsequently, they were asked about the recovery of physical activities they regularly performed prior to the onset of vertigo. Results: Sixty-nine patients (age: 57.79 ± 1...
Otology & Neurotology, 2019
Objectives: To compare the efficacy of the home treatment program combined with office-based canalith repositioning procedure (CRP) versus office-based CRP alone for benign paroxysmal positional vertigo (BPPV). Study Design: Randomized controlled trial. Method: One hundred six patients with BPPV were randomly assigned to the home treatment program combined with office-based CRP group and the office-based CRP only group. The canalith repositioning procedure was performed in all patients at an outpatient clinic. The patients in the home treatment group were additionally instructed to do the exercise tailored for their affected canal at home every day. The presence of nystagmus was recorded. The symptom of vertigo and its impact on daily life were evaluated by the Dizziness Handicap Inventory (DHI) and a visual analog scale (VAS). All outcomes were evaluated at 1, 2, and 4 weeks after the initial treatment. A cure was defined as a patient having no nystagmus on the appointment date. Results: The success rate of the home treatment program combined with office-based CRP group and the office-based CRP only group were 100 and 91.67%, respectively (p ¼ 0.043). The nystagmus duration, latency, DHI, and VAS scores decreased significantly from baseline at 1, 2, and 4 weeks for both groups (p < 0.001). No significant side effects were noted in either of the groups. Conclusion: The office-based CRP plus home treatment program was more effective than the CRP only group for BPPV. Both groups were effective in reducing the symptom of vertigo and its impact on daily life. Trial Registration: Clinicaltrials.in.th/TCTR20160810001
Benign paroxysmal positional vertigo recurrence and persistence
Brazilian Journal of Otorhinolaryngology (impresso), 2009
Beni gn paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. Aim: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year. Study design: longitudinal contemporary cohort series. Materials and Methods: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR) protocol was applied in cases of persistent BPPV. Results: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.