Benign paroxysmal positional vertigo may be the most common cause of dizziness in emergency department

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Duration Of Symptoms ◽

Common Cause ◽

Patient Profile ◽

Positional Vertigo ◽

Age Range ◽

Background: - Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. The diagnosis is often delayed and patients are unnecessarily investigated and treated with drugs. Aim: To analyze the patient profile, duration of symptoms, etiology, associated co-morbidities, type of canal involvement and response to CRP in cases of BPPV. Material & Methods: The present prospective study was conducted at a tertiary care centre from January 2015 to December 2016 in 90 patients with a clinical diagnosis of BPPV. Patient particular and disease specific data were recorded in preset profoma and analyzed. All these patients were treated by different CRP specific for the canal involved. All cases were reassessed for post procedural response. Results: Total 90 patients were included in the study with age range of 20 to 76 year. Mean age was 46.74. Maximum patients (26.67%) were in the age range of 41-50 year with male: female was 1:1.43. The duration of symptoms was in from 2 days to more than 3 years. Most common morbidity was diabetes and most common cause was Idiopathic (82.22%). Most of these patients presented with positional vertigo (94.44%). Right posterior canal was involved in 52 cases (57.78%) and left in 30 (33.33%) cases. Conclusion: BPPV is a common cause of vertigo. More awareness needed about its symptoms, early application of Dix-Hallpike test and Epley’s procedure to reduce the suffering of patients and to reduce unnecessary diagnostic tests and costs.

Evaluation of the Tp-e interval and Tp-e/QTc ratio in patients with benign paroxysmal positional vertigo in the emergency department compared with the normal population

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2019.11.002 ◽

2020 ◽

Vol 58 ◽

pp. 51-55 ◽

Cited By ~ 1

Author(s):

Özge Turgay Yıldırım ◽

Şeyhmus Kaya ◽

Filiz Baloğlu Kaya

Keyword(s):

Emergency Department ◽

Normal Population ◽

Positional Vertigo ◽

Diagnosis of benign paroxysmal positional vertigo in Emergency Department: Our experience

Audiology Research ◽

10.4081/audiores.2020.232 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Elisabetta Cristiano ◽

Vincenzo Marcelli ◽

Antonio Giannone ◽

Stefania De Luca ◽

Flavia Oliva ◽

...

Keyword(s):

Emergency Department ◽

Semicircular Canals ◽

Medical Personnel ◽

Head Movements ◽

Positional Vertigo ◽

Training Activities ◽

Peripheral Vertigo ◽

Observation Period ◽

The Benign Paroxysmal Positional Vertigo (BPPV) represents the first cause of peripheral vertigo in populations and it is determined by a displacement of otoconial fragments within the semicircular canals. Following the patient’s head movements, these fragments, moving by inertia, incorrectly stimulate the canals generating vertigo. The BPPV is diagnosable by observing the nystagmus that is generated in the patient following the Dix-Hallpike maneuver used for BPPV diagnosis of vertical semi-circular canal, and, following the supine head yaw test used for lateral semi-circular canal. Correctly identifying the origin of this specific peripheral vertigo, would mean to obtain a faster diagnosis and an immediate resolution of the problem for the patient. In this context, this study aims to identify precise training activities, aimed at the application of specific diagnostic maneuverers for algorithm decisions in support of medical personnel. The evaluations reported in this study refer to the data collected in the Emergency Department of the Cardarelli Hospital of Naples. The results obtained, over a six-month observation period, highlighted the advantages of the proposed procedures in terms of costs, time and number of BPPV diagnoses.

Benign paroxysmal positional vertigo: Early diagnosis and treatment by physical maneuver in the emergency department

Qatar Foundation Annual Research Forum Proceedings ◽

10.5339/qfarf.2013.biop-072 ◽

2013 ◽

pp. BIOP 072

Author(s):

Furqan Irfan

Keyword(s):

Emergency Department ◽

Early Diagnosis ◽

Diagnosis And Treatment ◽

Positional Vertigo ◽

Acute dizziness in rural practice: Proposal of a diagnostic procedure

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.153238 ◽

2015 ◽

Vol 6 (02) ◽

pp. 272-276

Author(s):

Ehab Eid ◽

Sajed Dastan ◽

Josef G. Heckmann

Keyword(s):

Emergency Department ◽

Posterior Fossa ◽

Diagnostic Procedure ◽

White Shark ◽

Posterior Circulation ◽

Rural Practice ◽

Clinical Routine ◽

Positional Vertigo ◽

ABSTRACTAcute dizziness is a frequent index symptom in the emergency department as well as in the rural practice office. Most acute dizziness, however, is not dangerous, but some types are highly dangerous. Clinical routine acute dizziness can be separated into frequent benign syndromes including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Menière’s disease or vestibular migraine, and what is here referred to as the “white shark” of dizziness, i.e. a stroke in the posterior circulation or more rarely a tumor in the posterior fossa. A practical concept is presented to clarify most frequent acute dizziness syndromes using clinical and low budget methods.

Effects of cranial osteopathic techniques in the symptoms of benign positional paroxistic vertical

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2020.18.788 ◽

2020 ◽

Vol 18 ◽

pp. 1-5

Author(s):

Otávio Augusto do Nascimento Oliveira ◽

Laiana Sepúlveda de Andrade Mesquita ◽

Maurício Rocha Mendes ◽

Lílian Maria Magalhães Costa de Oliveira ◽

Laís Cristina Almeida

Keyword(s):

Statistical Analysis ◽

Intervention Group ◽

Control Group ◽

Common Cause ◽

A Value ◽

Positional Vertigo ◽

Before And After ◽

Temporal Bones ◽

Background: The benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness among the population. The osteopathy is a practice of manual therapy which is guided by a holistic perspective of human being, the cranial osteopathy affirms that the respective bones of the cranium represent mobility. Objective: To investigate the effect of the cranial osteopathy techniques on the benign paroxysmal positional vertigo. Methods: The current study included 20 female subjects, each one of them with benign paroxysmal positional vertigo, distributed in two groups, an intervention group and a control group (placebo); in order to detect the BPPV, was applied the Dix-Hallpike test before and after the interventions. Three techniques of cranial osteopathy were used on the structures related to vestibule and to the temporal bones: mobilization of temporal bones, tensioning of cerebellar tentorium and mobilization of eyeball. All statistical analyzes were performed using the GraphPad Prism 6.0 software (GraphPad Software, CA).Results: Among the intervention group, 7 of 10 individuals were negative to the Dix-Hallpike test, whilst individuals of the control group remained positive to the test. In the statistical analysis verified that the intervention with osteopathic techniques had a significant effect in compared to the control group, with a value p=0.0261. Conclusion: The cranial osteopathy appears to be able of produce effects on the vestibular activity, whereas were able to reduce, in a significant means, the symptoms concerning to BPPV.

Effect of vitamin D levels in benign paroxysmal positional vertigo

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212355 ◽

2021 ◽

Author(s):

Shweta Sawant ◽

Taranath Nandini ◽

Rajashree Partabad

Keyword(s):

Vitamin D ◽

Semicircular Canals ◽

Vitamin D Supplementation ◽

High Rate ◽

Common Cause ◽

Rehabilitation Therapy ◽

Positional Vertigo ◽

Vitamin D Levels ◽

Background: Benign paroxysmal positional vertigo (BPPV) is a common cause of disabling vertigo with a high rate of recurrence. BPPV is the most common cause of neurotological disorder. It is caused by dislodged otoconia which fall from the utricular macula and float into the semicircular canals there by making them sensitive to gravity. It has been shown that elderly people may suffer from unrecognized, chronic BPPV. Patients with unrecognized BPPV were more likely to have reduced activity of daily living scores, to have sustained a fall in the previous 3 months and to have depression.Methods: A prospective study of 100 patients with clinical diagnosis of BPPV visiting Navodaya medical college and hospital between June 2019 to May 2020 were included in the study.Results: Patients taking both vitamin D supplementation and rehabilitation therapy improved better than patients taking rehabilitation therapy alone.Conclusions: Both rehabilitation therapy and supplementation of vitamin D is helpful in patients with vitamin D deficient BPPV patients.

Benign paroxysmal positional vertigo in emergency department: How to treat?

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907920972283 ◽

2020 ◽

pp. 102490792097228

Author(s):

Muge Gulen ◽

Salim Satar ◽

Selen Acehan ◽

Akkan Avci ◽

Adem Kaya ◽

...

Keyword(s):

Emergency Department ◽

Demographic Data ◽

Tertiary Hospital ◽

Study Data ◽

Medical Treatments ◽

Positional Vertigo ◽

Epley Maneuver ◽

Scale Scores ◽

Background: The treatment of benign paroxysmal positional vertigo (BPPV) has not been well studied. Many clinicians are indifferent about canalith reposition maneuvers and frequently prefer medical treatments. Objectives: We aimed to detect efficacy of Epley maneuver in relieving symptoms of benign paroxysmal positional vertigo patients diagnosed in emergency department and if medical treatments are useful in patients whose symptoms were not relieved. Methods: The study was conducted as a prospective cohort study in the emergency department of a tertiary hospital. Patients who were over 18 years of age and presented to emergency department with complaints of vertigo symptoms and nausea and had a positive Dix–Hallpike test were included in the study. Patients’ demographic data, possible etiological factors, affected ear, and benign paroxysmal positional vertigo diagnosis in the history were recorded on the study data form. The European Evaluation of Vertigo scale and the Visual Analogue Scale (VAS) score of nausea and vertigo symptoms were graded and recorded for each patient before and after treatment. Results: Ninety patients were included in the study in total. Epley maneuver was carried out to all patients. Vertigo symptoms VAS (VASd) score (p < 0.001), nausea and vomiting VAS (VASnv) score (p < 0.001), and European Evaluation of Vertigo scale score (p < 0.001) of all patients showed a statistically significant decrease after Epley maneuver. A combination of dimenhydrinate and metoclopramide helped to reduce VASd (p = 0.048), VASnv (p = 0.031), and European Evaluation of Vertigo scale scores (p = 0.001) at a statistically significant level more than dimenhydrinate treatment alone. Conclusions: Epley maneuver may be applied to every patient with benign paroxysmal positional vertigo. Dimenhydrinate and/or metoclopramide helps to control patients’ symptoms whose symptoms remain despite Epley maneuver.