scholarly journals Diabetes and the Vestibular System

2019 ◽  
Vol 40 (04) ◽  
pp. 300-307 ◽  
Author(s):  
Erin G. Piker ◽  
Daniel J. Romero
Keyword(s):  
Diabetes Mellitus ◽  
Vestibular System ◽  
Benign Paroxysmal Positional Vertigo ◽  
Large Population ◽  
Population Based ◽  
Vestibular Disorder ◽  
Vestibular Loss ◽  
Positional Vertigo ◽  
Patients With Diabetes ◽  
Paroxysmal Positional Vertigo

AbstractFalls are among the most injurious, costly, and feared conditions affecting older adults. Patients with diabetes have a significantly greater risk for falling due to complications affecting the sensory systems required for balance: vision, proprioception, and vestibular. The effects of diabetes mellitus on the vestibular system are perhaps the least understood of these systems. The vestibular system is complex, includes multiple structures, and is difficult and expensive to thoroughly assess. There is pathophysiologic evidence suggesting a direct effect of diabetes mellitus complications on the vestibular system, but there is limited clinical evidence regarding which specific vestibular structures are most adversely affected. Nevertheless, large population-based studies show that patients with diabetes are more likely to have vestibular loss, have a high prevalence of a specific vestibular disorder called benign paroxysmal positional vertigo, and are at a greater risk for falling. Based on the available evidence, a balance screening and an evaluation of benign paroxysmal positional vertigo, a common but easy to treat pathology, in patients with diabetes is recommended as well as counseling on falls risk and home modifications.

scholarly journals Potential Autoimmune Association between Benign Paroxysmal Positional Vertigo and Immune-mediated Skin Conditions: Population-based Cohort Study

2019 ◽  
Author(s):  
Hyung Jin Hahn ◽  
Sang Gyu Kwak ◽  
Dong-Kyu Kim ◽  
Jong-Yeup Kim
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Large Population ◽  
Population Based ◽  
Positional Vertigo ◽  
Immune Mediated ◽  
Common Skin ◽  
Autoimmune Conditions ◽  
Skin Conditions ◽  
Paroxysmal Positional Vertigo

ABSTRACTBackgroundBenign paroxysmal positional vertigo (BPPV), an idiopathic disorder of sudden sensorineural hearing loss and vertigo, shares many similarities with two common skin conditions, atopic dermatitis (AD) and vitiligo. Recent studies have suggested that BPPV may be related to or triggered by autoimmune conditions, notably hypothyroidism and giant cell arteritis (GCA).ObjectiveThese evidences prompted the authors to entertain the possibility of immunological bridge between BPPV and the two skin conditions. The authors have tested this hypothesis with population-based cohort from the National Health Insurance Service Database of Korea.MethodsA cohort of 1.1 million patients was extracted from the DB. Using χ2 tests, prevalence of the two skin disorders in terms of BPPV status was analysed.ResultsIn AD patients, the prevalence of BPPV was 30% lower, while there was no statistically significant relationship between BPPV prevalence and vitiligo. The relationship between vitiligo and BPPV was significant in younger subgroup only. Socio-economic subgroup analysis revealed the observed patterns are primarily a middle-upper class phenomenon.LimitationsUncertainty regarding temporal sequence of onset, and lack of detail on disease severity and subtype might have kept the authors from drawing more refined conclusion.ConclusionAD and vitiligo might be linked to BPPV through the action of certain components of cellular immunity, but follow-up studies based on large population cohort would be needed to add more substance to our findings.

scholarly journals Teleconsultation and Teletreatment Protocol to Diagnose and Manage Patients with Benign Paroxysmal Positional Vertigo (BPPV) during the COVID-19 Pandemic

2021 ◽  
Vol 25 (01) ◽  
pp. e141-e149
Author(s):  
Renato Gonzaga Barreto ◽  
Darío Andrés Yacovino ◽  
Lázaro Juliano Teixeira ◽  
Mayanna Machado Freitas
Keyword(s):  
Disease Transmission ◽  
Benign Paroxysmal Positional Vertigo ◽  
Good Clinical Practice ◽  
Relevant Information ◽  
Remote Access ◽  
Vestibular Disorder ◽  
Face To Face ◽  
Positional Vertigo ◽  
Video And Audio ◽  
Paroxysmal Positional Vertigo

Abstract Introduction Telehealth consists in the application of technology to provide remote health service. This resource is considered safe and effective and has attracted an exponential interest in the context of the COVID pandemic. Expanded to dizzy patients, it would be able to provide diagnosis and treatment, minimizing the risk of disease transmission. Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder. The diagnosis typically rests on the description of the symptoms along with the nystagmus observed at a well-established positional testing. Objectives The aim of the present study was to propose a teleconsultation and teletreatment protocol to manage patients with BPPV during the COVID-19 pandemic. Methods Specialists in the vestibular field met through remote access technologies to discuss the best strategy to manage BPPV patients by teleconsultation and teletreatment system. Additionally, several scientific sources were consulted. Technical issues, patient safety, and clinical assessment were independently analyzed. All relevant information was considered in order to design a clinical protocol to manage BPPV patients in the pandemic context. Results Teleconsultation for BPPV patients requires a double way (video and audio) digital system. An adapted informed consent to follow good clinical practice statements must be considered. The time, trigger and target eye bedside examination (TiTRaTe) protocol has proven to be a valuable first approach. The bow and lean test is the most rational screening maneuver for patients with suspected positional vertigo, followed by most specific maneuvers to diagnostic the sub-variants of BPPV. Conclusion Although with limited evidence, teleconsultation and teletreatment are both reasonable and feasible strategies for the management of patients with BPPV in adverse situations for face-to-face consultation.

scholarly journals Benign Paroxysmal Positional Vertigo in Children and Adolescents With Concussion

2021 ◽  
pp. 194173812097051
Author(s):  
Alicia Wang ◽  
Guangwei Zhou ◽  
Kosuke Kawai ◽  
Michael O’Brien ◽  
A. Eliot Shearer ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Pediatric Patients ◽  
Head Injuries ◽  
Vestibular Disorder ◽  
Symptom Scale ◽  
Level Of Evidence ◽  
Pediatric Concussion ◽  
Positional Vertigo ◽  
Level 3 ◽  
Paroxysmal Positional Vertigo

Background: Dizziness after concussion is primarily attributed to effects on the brain, but traumatic inner ear disorders can also contribute. Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder that can result from minor head trauma and can be easily diagnosed and rapidly treated in an office setting. The role of BPPV in pediatric postconcussive dizziness has not been well-studied. Purpose: To evaluate the prevalence and clinical features of BPPV in a group of pediatric patients with concussion and prolonged dizziness after concussion. Study Design: Case-control study. Level of Evidence: Level 3. Methods: Retrospective review of 102 patients seen within the past 3 years in a pediatric multidisciplinary concussion clinic for evaluation of postconcussive dizziness. Results: BPPV was diagnosed in 29.4% (30/102) of patients with postconcussion syndrome and dizziness. All patients with BPPV were treated with repositioning maneuvers, except for 5 patients who had spontaneous resolution of symptoms. Patients were evaluated at an average of 18.8 weeks (SD, 16.4 weeks) after the injury. BPPV was diagnosed at similar rates regardless of gender or age group (children vs adolescents). The mean Post-Concussion Symptom Scale (PCSS) score did not differ significantly between patients with (58.3 [SD, 22.5]) or without BPPV (55.8 [SD, 29.4]; P = 0.39). The PCSS “balance problems or dizziness” subscore also did not differ between patients with (3.3 [SD, 1.7]) or without BPPV (2.8 [SD, 1.6]; P = 0.13). Conclusion: BPPV is fairly common in pediatric concussion, occurring in one-third of the patients studied. BPPV is often not diagnosed and treated until many weeks after the injury. Increased awareness of the evaluation and management of BPPV among pediatric concussion providers may help expedite resolution of dizziness and hasten overall recovery in affected patients. Clinical Relevance: BPPV is a treatable cause of dizziness caused by minor head injuries and is more common than previously reported in pediatric patients with concussion. Improved awareness of BPPV by concussion providers may expedite recovery.

scholarly journals Residual dizziness after successful repositioning maneuver for idiopathic benign paroxysmal positional vertigo: a review

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Giorgia Giommetti ◽  
Ruggero Lapenna ◽  
Roberto Panichi ◽  
Puya Dehgani Mobaraki ◽  
Fabrizio Longari ◽  
...  
Keyword(s):  
English Language ◽  
Benign Paroxysmal Positional Vertigo ◽  
Early Recognition ◽  
The Elderly ◽  
Vestibular Disorder ◽  
Risk Of Falling ◽  
Search Terms ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

The benign paroxysmal positional vertigo (BPPV) is a vestibular disorder cause of vertigo. The BPPV may be corrected mechanically by repositioning maneuvers but even after successful maneuvers, some patients report residual dizziness for a certain period afterward. Early recognition and treatment might decrease the incidence of residual dizziness in patients with BPPV, especially in those patients with psychiatric comorbidities and in the elderly, lowering the risk of falling. Many pathogenetic hypotheses for residual dizziness are under debate. The purpose of this review was to identify, evaluate and review recent researches about possible causal factors involved in residual dizziness and the implications on clinical practice. A literature search was performed using different databases such as Pubmed and Scopus. The following search terms were used: <em>residual dizziness, otolithic membrane and BPPV</em>. The search found a total of 1192 titles, which were reduced to 963 after a procedure of de-duplication of the found titles. The research was then restricted to an interval of time comprised between 2000 and 2016 for a total of 800 titles. Among these titles, only those including the terms <em>benign paroxysmal positional vertigo</em> were considered eligible for this review. Only publications in English language were taken into consideration and we excluded those with not available abstract. Finally, 90 abstracts were obtained and critically evaluated by two different Authors, and additional studies were identified by hand searching from the references of artiche of interest. Only 53 were included in this work.

scholarly journals Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1056
Author(s):  
Cristiano Balzanelli ◽  
Daniele Spataro ◽  
Luca Oscar Redaelli de Zinis
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Clinical History ◽  
Diagnostic Process ◽  
Clinical Documentation ◽  
Vestibular Loss ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.

scholarly journals Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review

2021 ◽  
Vol 10 (19) ◽  
pp. 4372
Author(s):  
Ioanna Sfakianaki ◽  
Paris Binos ◽  
Petros Karkos ◽  
Grigorios G. Dimas ◽  
George Psillas
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Recurrence Rate ◽  
Benign Paroxysmal Positional Vertigo ◽  
Female Gender ◽  
Recurrence Rates ◽  
Positional Vertigo ◽  
Risk Factors For Recurrence ◽  
Paroxysmal Positional Vertigo

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 osteoporosis, vitamin D deficiency, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, migraine, bilateral/multicanal BPPV, cervical osteoarthrosis and sleep disorders. Patients with hyperlipidemia and hypertension had the highest recurrence rates of BPPV, 67.80% and 55.89%, respectively, indicating that vascular comorbidities increase the risk of BPPV recurrence. In addition, more than half of patients (53.48%) with diabetes mellitus and BPPV experienced recurrence of BPPV. Knowledge and awareness of risk factors for recurrence of BPPV are essential for the assessment and long-term prognosis of patients. Identification of these relapse risk factors may enhance the ability of clinicians to accurately counsel patients regarding BPPV and associated comorbidities.

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