Vertical nystagmus during the seated–supine positional (straight head-hanging) test in patients with benign paroxysmal positional vertigo

2014 ◽  
Vol 128 (8) ◽  
pp. 674-678 ◽  
Author(s):  
S Yetiser ◽  
D Ince
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Case Series ◽  
The Other ◽  
Aetiological Factor ◽  
Retrospective Case ◽  
Duration Of Symptoms ◽  
Positional Vertigo ◽  
Vertical Nystagmus ◽  
Vertical Up ◽  
Paroxysmal Positional Vertigo

AbstractObjective:This study describes the clinical features of up-beating vertical nystagmus observed during the seated–supine positional (straight head-hanging) test in patients with benign paroxysmal positional vertigo.Methods:A total of 190 patients with benign paroxysmal positional vertigo symptoms who had presented between 2009 and 2012 were enrolled for this retrospective case series. Twelve patients with positional up-beating vertical nystagmus, as confirmed by video-nystagmography during the seated–supine positional test, were selected.Results:The incidence and duration of symptoms of multiple canal benign paroxysmal positional vertigo were significantly lower compared with the other types of benign paroxysmal positional vertigo (p = 0.029 and p = 0.048 respectively). Trauma was the leading aetiological factor in those patients (p = 0.012). The average number of therapeutic manoeuvres required for the relief of symptoms in patients with multiple canal involvement was significantly higher than in the other groups (p = 0.041).Conclusion:In patients with benign paroxysmal positional vertigo, the presence of vertical up-beating nystagmus while lying down is a unique peripheral sign and could indicate multiple canal involvement. Therefore, the seated–supine positional test should always be included in the test battery.

scholarly journals Clinico-Aetiological Profile of Patients with Vertigo: A Cross-sectional Observational Study

2020 ◽  
Author(s):  
Shiraz Syed ◽  
Himanshu Kumar Mittal ◽  
Sampan Singh Bist ◽  
Lovneesh Kumar ◽  
Vinish Kumar Agarwal
Keyword(s):  
Observational Study ◽  
Orthostatic Hypotension ◽  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care ◽  
Aetiological Factor ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Introduction: Nearly 5-10 percent of patients seen in general OPD, and between 10-20 percent of patients seen by ENT specialists and neurologists are those with complaints pertaining to vertigo and dis-equilibrium. The standard definition of vertigo states it to be an illusion of motion particularly rotatory sensation. Overlapping symptoms and terms such as dizziness, light headedness, giddiness and pre-syncope make it challenging to achieve a proper diagnosis. Aim: To study the clinical profile and revisit the various aetiological factors for vertigo in patients with actual sensation of rotatory motion seen in contemporary Otolaryngology practice. Materials and Methods: The present study was a cross-sectional observational study carried out over a period of 12 months in the Department of Otorhinolaryngology at a tertiary care centre. One-hundred and ten cases complaining of the sense of rotation of either head or their surroundings with at least a single episode in preceding one month were included. Comprehensive otological and vestibular evaluation was done. Each patient was subjected to thorough clinical vestibular and laboratory tests. Subjects with known cervical spine disease, neurological disorders and cardiac ailments were excluded. Statistical analysis was done and Chi-square test was applied. Results: The mean age of patients in the study was 49.75 years with a male to female ratio of 1:1. Majority of the patients (90%) presented with acute onset of vertigo. The total duration of symptoms most commonly observed ranged between one week to one month. Nearly, all patients had intermittent character of vertigo. The duration of each episode in most of the patients ranged between 1 minute to 10 minutes. Maximum patients (90.9%) were observed with intensity of vertigo as mild and moderate type (Level II and III SVVSLCRE). Positional variation was observed in 64.5% of the patients. The most common aetiological diagnosis deduced from the study was benign paroxysmal positional vertigo (30.4%) followed by orthostatic hypotension (17.9%) and Meniere’s disease (13.4%). Conclusion: The most common aetiological factor of vertigo was found to be benign paroxysmal positional vertigo, which can be effectively treated by performing Epley’s maneuver. Orthostatic hypotension has been observed as an important cause liable to be missed by otologists. The management of vertigo must be directed by a meticulous work up of aetiologies and should not be treated under a blanket regimen.

scholarly journals BENIGN PAROXYSMAL POSITIONAL VERTIGO: OUR EXPERIENCE AT A TERTIARY CARE CENTRE OF CENTRAL INDIA

2020 ◽  
pp. 1-3
Author(s):  
Patel Meghraj Singh
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Duration Of Symptoms ◽  
Common Cause ◽  
Patient Profile ◽  
Positional Vertigo ◽  
Age Range ◽  
Paroxysmal Positional Vertigo

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.

Prognosis of patients with benign paroxysmal positional vertigo treated with repositioning manoeuvres

2006 ◽  
Vol 120 (7) ◽  
pp. 528-533 ◽  
Author(s):  
S Korres ◽  
D G Balatsouras ◽  
E Ferekidis
Keyword(s):  
Treatment Outcome ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Benign Paroxysmal Positional Vertigo ◽  
Duration Of Symptoms ◽  
Repeat Treatment ◽  
Positional Vertigo ◽  
Small Subgroup ◽  
Duration Of Disease ◽  
Paroxysmal Positional Vertigo

Objective: To evaluate the prognostic factors in benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning procedures (CRPs).Material and methods: Retrospective study of consecutive BPPV cases diagnosed over three years. All patients underwent a complete otolaryngologic, audiologic and neurotologic evaluation. The appropriate CRP was performed, depending on the type of BPPV. Prognostic factors studied included age, sex, aetiology, duration of disease, abnormal electronystagmographic findings, canal involvement, improper performance of manoeuvres, response on first or repeat treatment, and presence of recurrences.Results: One hundred and fifty-five patients were studied, 66 men and 89 women, with mean ages of 58.7 and 60.4 years, respectively. Age and the involvement of two canals or bilateral disease had an effect on initial treatment outcome and were correlated to increased recurrences but not to repeat treatment outcome. Secondary BPPV, abnormal electronystagmographic findings and improper performance of manoeuvres had a significant effect both on initial and repeat treatment, but not on recurrences. Sex and duration of symptoms had no effect.Conclusion: Canalith repositioning procedures provide fast and long-lasting treatment of BPPV in most patients. However, in a small subgroup of patients, failures may be noticed that may be attributed to various prognostic factors.

Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness

2014 ◽  
Vol 128 (2) ◽  
pp. 128-133 ◽  
Author(s):  
M Lüscher ◽  
S Theilgaard ◽  
B Edholm
Keyword(s):  
Multicentre Study ◽  
Study Design ◽  
Benign Paroxysmal Positional Vertigo ◽  
Age Groups ◽  
Significant Proportion ◽  
The Elderly ◽  
The Other ◽  
Night Time ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To determine the prevalence and characteristics of various diagnostic groups amongst patients referred to ENT practices with the primary complaint of dizziness.Study design:A prospective, observational, multicentre study.Methods:Consecutive patients presenting with dizziness to the participating ENT practices were enrolled. Seven ENT specialists at three clinics participated.Results:Benign paroxysmal positional vertigo was diagnosed in 53.3 per cent of the 1034 study patients. Fifty-nine per cent of these experienced night-time awakening with dizziness, which was a significant proportion in comparison to the other diagnostic groups. Benign paroxysmal positional vertigo was the most frequent diagnosis in all age groups, including those over 70 years.Conclusion:In this study of patients referred to ENT for dizziness, benign paroxysmal positional vertigo was the dominant diagnostic entity, in all age groups and overall. All clinicians in contact with dizzy patients must consider benign paroxysmal positional vertigo, especially in the elderly.

scholarly journals Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal

2012 ◽  
Vol 69 (8) ◽  
pp. 669-674 ◽  
Author(s):  
Snezana Babac ◽  
Nenad Arsovic
Keyword(s):  
Success Rate ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Spontaneous Nystagmus ◽  
Posterior Semicircular Canal ◽  
Duration Of Symptoms ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Background/Aim. Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders. The aim of this study was to examine the efficacy of the Epley maneuver in treating benign paroxysmal positional vertigo of the posterior semicircular canal (p- BPPV) and to discover possible causes of failure. Methods. This prospective study included 75 patients. In all the cases medical history showed and the positioning Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed clinical ENT examination, searching for spontaneous nystagmus, vestibulospinal tests, caloric test, and audiometry. All the patients were treated by the modified Epley canalith repositioning maneuver. The patients were followed up at the intervals of seven and, fourteen days, and one, tree, and six months and one year. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. Results. After the initial Epley maneuver the recovery rate was 90.7%, and after the second 96%. In three (4%) patients with secondary p-BPPV, symptoms did not cease even after the second repositioning maneuver. The etiology of p-BPPV had a significant effect on the maneuver?s success rate (p < 0.01), whereas duration of symptoms, age and gender had no effect (p > 0.05). After a successful treatment 11 (14.66%) patients had recurrent attack of BPPV during the first year. Conclusion. The Epley maneuver is very successful repositioning procedure in treating p- BPPV. The patients with idiopathic form p-BPPV showed higher success rate with Epley maneuver than those with secondary p-BPPV.

Short- and Long-Term Outcomes of Canalith Repositioning for Benign Paroxysmal Positional Vertigo

2000 ◽  
Vol 122 (5) ◽  
pp. 647-653 ◽  
Author(s):  
Robert A. Nunez ◽  
Stephen P. Cass ◽  
Joseph M. Furman ◽  
G. Richard Holt
Keyword(s):  
Recurrence Rate ◽  
Benign Paroxysmal Positional Vertigo ◽  
Duration Of Symptoms ◽  
Telephone Interviews ◽  
Positional Vertigo ◽  
Kaplan Meier ◽  
Study Population ◽  
Short And Long Term ◽  
Canalith Repositioning Procedure ◽  
Paroxysmal Positional Vertigo

This is a prospective, nonrandomized study of the canalith repositioning procedure (CRP) for treatment of benign paroxysmal positional vertigo (BPPV). CRP was used to treat 168 patients with BPPV. Patient data were gathered by yearly telephone interviews to determine whether symptoms of position-induced vertigo had returned. After 1 or 2 treatment sessions 91.3% of patients reported complete symptom resolution. Average follow-up for the study population after the initial treatment was 26 months. A recurrence rate of 26.8% was found among those patients who initially reported resolution of symptoms after CRP. Application of recurrence data to a Kaplan-Meier estimation suggests a 15% recurrence rate per year of BPPV, with a 50% recurrence rate of BPPV at 40 months after treatment. There was no significant association between cure or recurrence rate and sex, age, duration of symptoms, presumed cause, or treating physician.

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