scholarly journals Benign Paroxysmal Positional Vertigo and Occult Subarachnoid Hemorrhage Complicated after Head Trauma

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Qinghua Li ◽  
Shuangxing Hou ◽  
Hualan Yang
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Head Trauma ◽  
Benign Paroxysmal Positional Vertigo ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Positional Vertigo ◽  
Mri Sequences ◽  
Peripheral Vertigo ◽  
Prevalent Form ◽  
Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most prevalent form of peripheral vertigo and is common in posttraumatic patients. Sometimes, posttraumatic BPPV and subarachnoid hemorrhage (SAH) exist together. How to effectively recognize SAH especially concealed bleeding before maneuver treatment for BPPV is worth paying attention by every clinician. Presently described is a case that when there are some clinical symptoms cannot be completely explained by simple BPPV, the combination of CT and FLAIR MRI sequences are needed in the early-stage detection of acute SAH.

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

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elisabetta Cristiano ◽  
Vincenzo Marcelli ◽  
Antonio Giannone ◽  
Stefania De Luca ◽  
Flavia Oliva ◽  
...  
Keyword(s):  
Emergency Department ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Medical Personnel ◽  
Head Movements ◽  
Positional Vertigo ◽  
Training Activities ◽  
Peripheral Vertigo ◽  
Observation Period ◽  
Paroxysmal Positional Vertigo

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 Secondary to Mild Head Trauma

2016 ◽  
Vol 126 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Dimitrios G. Balatsouras ◽  
George Koukoutsis ◽  
Andreas Aspris ◽  
Alexandros Fassolis ◽  
Antonis Moukos ◽  
...  
Keyword(s):  
Head Trauma ◽  
Medical Records ◽  
Benign Paroxysmal Positional Vertigo ◽  
Spontaneous Nystagmus ◽  
Control Group ◽  
Imaging Evaluation ◽  
Canal Paresis ◽  
Positional Vertigo ◽  
Anterior Semicircular Canal ◽  
Paroxysmal Positional Vertigo

Objectives: We studied the clinical characteristics, nystagmographic findings, and treatment outcome of a group of patients with benign paroxysmal positional vertigo (BPPV) secondary to mild head trauma and compared them with a group of patients with idiopathic BPPV. Methods: The medical records of 33 patients with BPPV associated with mild head trauma were reviewed. Data of a complete otolaryngological, audiological, neurotologic, and imaging evaluation were available for all patients. Three hundred and twenty patients with idiopathic BPPV were used as a control group. Results: The patients with BPPV secondary to mild head trauma presented the following features, in which they differed from the patients with idiopathic BPPV: (1) lower mean age, with more intense symptoms; (2) increased rate of horizontal and anterior semicircular canal involvement and frequent multiple canal and bilateral involvement; (3) greater incidence of canal paresis and presence of spontaneous nystagmus; (4) poorer treatment results, attributed mainly to coexisting canal paresis in many patients, and higher rate of recurrence. Conclusions: Benign paroxysmal positional vertigo associated with mild head trauma differs from idiopathic BPPV in terms of several epidemiological and clinical features; it responds less effectively to treatment and is prone to recurrence.

scholarly journals “Family Medicine Approach sebagai Tatalaksana Benign Paroxysmal Positional Vertigo (BPPV) Kanal Posterior Kanan Komorbid Hipertensi pada Perempuan Usia 49 Tahun: Sebuah Laporan Kasus”

2020 ◽  
Vol 1 (2) ◽  
pp. 10
Author(s):  
Angga Hendro Priyono ◽  
Azelia Nusadewiarti
Keyword(s):  
Family Medicine ◽  
Evidence Based Medicine ◽  
Benign Paroxysmal Positional Vertigo ◽  
Clinical Symptoms ◽  
Evidence Based ◽  
Family Approach ◽  
Dental Implantation ◽  
Positional Vertigo ◽  
Based Medicine ◽  
Paroxysmal Positional Vertigo

ABSTRAK   Insidensi terjadinya kasus BPPV di dunia mencapai 64/100.000 yang paling banyak melibatkan kanalis semisirkularis posterior unilateral. Lima puluh persen penyebabnya adalah idiopatik, diikuti dengan kasus trauma kepala, neuritis vestibularis, migrain, implantasi gigi dan mastoiditis kronis. Sebuah kasus pusing berputar disertai dengan mual dan muntah pada perempuan usia 49 tahun sejak 3 jam sebelum datang ke Puskesmas Rawat Inap Simpur. Pasien memiliki riwayat vertigo sejak 3 tahun lalu dan riwayat hipertensi sejak 1,5 tahun yang lalu. Pemeriksaan fisik didapatkan tekanan darah 150/90 mmHg dengan IMT 25,3 (pemeriksaan fisik lain dalam batas normal).Pemeriksaan neurologis otologi didaptkan hasil Dix-Hallpike maneuver vertigo positif dengan nistagmus cepat ke kiri. Dilakukan intervensi dengan pendekatan dokter keluarga berupa tindakan Epley manuver selama perawatan di puskesmas serta pemberian betahistin mesylate 3 x 6 mg, difenhidramin HCl 4 x 25 mg, dan kaptopril 1 x 12,5 mg. Saat pulang pasien diberikan edukasi mengenai latihan vestibuler berupa Brandt-Daroff maneuver dan pola hidup sehat. Dilakukan follow up pada pasien sebanyak 4 kali dan didapatkan hasil keluhan berkurang lebih dari 50% sejak datang ke puskesmas, pusing hanya terasa pada saat bangun dari tidur. Penatalaksanaan BPPV kanalis posterior kanan yang diberikan pada kasus ini sudah sesuai dengan guideline dan penelitian terkini, terlihat perkembangan yang baik pada gejala klinis dan perubahan perilaku pasien setelah dilakukan intervensi berdasarkan evidence based medicine yang bersifat patient centred dan  family approach. Kata Kunci: BPPV, Dokter Keluarga, Kanal Posterior Kanan, Unilateral   ABSTRACT   The incidence of Benign Paroxysmal Positional Vertigo (BPPV) has been reported 64/100.000 in the world which mostly involves the unilateral posterior semicircular canal. Fifty percent of the cases are idiopathic, followed by cases of head trauma, vestibular neuritis, migraine, dental implantation, and chronic mastoiditis. Case: A Dizziness, nausea, and vomiting in 49 years old woman who came to the Simpur Primary Health Care (PHC) have been reported. She appeared to be overweight with BMI is 25,3. Her physical examinations were normal except blood pressure is 150/90 mmHg and Dix-Hallpike vertigo positive maneuver with fast nystagmus to the left. Family medicine approach was carried out as holistic and comprehensive management by performing Epley maneuvers during treatment at the PHC and the administration 3 x 6 mg of betahistine mesylate, 4 x 25 mg of diphenhydramine HCl, and 1 x 12.5 mg of captopril. Brandt-Daroff maneuver and healthy lifestyle education were given to her before she came home. There were 4 times follow-ups for patient and the results of complaints were reduced by more than 50% since coming to the PHC, dizziness was only felt when she is waking up from sleep. The diagnosis and management were given to the patient are by the guidelines and current research, there is a good development in clinical symptoms and changes in patient behavior after patient-centered and family approach intervention based on “evidence-based medicine”. Keywords: BPPV, Family Psychian, Right Posterior Channel, Unilateral

Vertigo, dizziness and imbalance in the elderly

2007 ◽  
Vol 122 (5) ◽  
pp. 466-469 ◽  
Author(s):  
A Üneri ◽  
S Polat
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Retrospective Analysis ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Elderly ◽  
Senior Author ◽  
Ménière’S Disease ◽  
Positional Vertigo ◽  
Peripheral Vertigo ◽  
Paroxysmal Positional Vertigo

AbstractObjective:The aim of this retrospective analysis was to evaluate the diagnosis of vertigo, dizziness and imbalance in elderly patients in two tertiary neurotology clinics.Design and setting:Six hundred and seventy-seven patients aged over 65 years were assessed by the same senior author, and 601 patients were enrolled in the study.Results:The most frequent diagnoses were benign paroxysmal positional vertigo (42.43 per cent), idiopathic vestibulopathy (20.29 per cent), migraine vestibulopathy (13.15 per cent), Ménière's disease (12.47 per cent) and acute vestibular attack (6.49 per cent).Conclusion and significance:This retrospective study showed that 93.5 per cent of the elderly patients studied had been diagnosed with peripheral vertigo. The majority of patients had been classified as having benign paroxysmal positional vertigo, idiopathic vestibulopathy or migraine vestibulopathy.

scholarly journals The Risk of Benign Paroxysmal Positional Vertigo After Head Trauma

2021 ◽  
Author(s):  
Helene Andersson ◽  
Greg Eigner Jablonski ◽  
Stein Helge Glad Nordahl ◽  
Karl Nordfalk ◽  
Eirik Helseth ◽  
...  
Keyword(s):  
Head Trauma ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Approach of management a patient with vertigo in out-patient practice: case of recurrent benign paroxysmal positional vertigo with vitamin D deficiency

2021 ◽  
Author(s):  
А.С. Беденко
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Benign Paroxysmal Positional Vertigo ◽  
Comorbid Condition ◽  
Metabolic Factors ◽  
Second Stage ◽  
Positional Vertigo ◽  
Peripheral Vertigo ◽  
Therapy Treatment ◽  
Paroxysmal Positional Vertigo

Головокружение является одной из наиболее частых причин обращения к неврологу. С возрастом частота головокружения возрастает. Первой целью невролога является дифференциация между центральным и периферическим головокружением. Вторым этапом необходимо провести детальный дифференциальный диагноз между нозологиями. Для решения этих задач врачу необходимо провести нейровестибулярное обследование, включающее пробу Хальмаги, тест с встряхиванием головы, тест Фукуда и обязательное проведение позиционных проб. Тактика дальнейшего ведения предполагает адекватную вертиголитическую терапию, лечение основного заболевания и создание плана реабилитации, которая включает в себя как вестибулярную гимнастику и другие нелекарственные методы (биологическая обратная связь, занятия на стабилоплатформе), так и препараты, улучшающие вестибулярную компенсацию. Периферическое головокружение встречается значительно чаще центрального, а самой распространенной причиной вращательного головокружения является доброкачественное пароксизмальное позиционное головокружение. По разным оценкам, до 85% случаев доброкачественного пароксизмального позиционного головокружения являются идиопатическими, у 50% наблюдается рецидивирование. В статье приведен клинический случай рецидивирующего доброкачественного пароксизмального позиционного головокружения с поражением нескольких каналов. Особенностью данного случая является его сочетание с дефицитом витамина D. На сегодняшний день накоплены данные, указывающие на то, что недостаточность и дефицит витамина D не просто коморбидное состояние, часто выявляемое у пациентов с доброкачественным пароксизмальным позиционным головокружением, но, вероятнее всего, фактор развития и рецидивирования доброкачественного пароксизмального позиционного головокружения. Однако данные достаточно противоречивы и требуют дальнейшего изучения. Выявление и коррекция метаболических факторов позволят оптимизировать терапию. Dizziness is one of the most frequent causes of appliance to neurologist. The occurrence of dizziness increases in elder groups. The first goal of a neurologist is the differentiation between central and peripherial vertigo. It is necessary for second stage to make detalized differential diagnosis. To realize this purpose doctor should carry out neurovestibular investigation, including HINT test, shaking-test,test Fukuda and mandatory performing of positional tests. The further management includes adequate vertigolytic therapy, treatment of the basic disease and creation of a rehabilitation scheme, which includes both vestibular gymnastics and other non-drug methods (biofeedback, exercises on a stabiloplatform), and drugs that improve vestibular compensation. Peripheral vertigo is much more common than central vertigo and is the most common cause spinning vertigo is a benign paroxysmal positional vertigo. According to various estimates, up to 85% of benign paroxysmal positional vertigo cases have idiopathic origin, frequency of relapse is about 50%. The article presents a clinical case of recurrent benign paroxysmal positional vertigo with multiple canal involvement. A feature of this case is its combination with a vitamin D deficiency. Today, data have been accumulated indicating that vitamin D deficiency and insufficency is not just a comorbid condition often detected in patients with benign paroxysmal positional vertigo, but, most likely, is a factor in the development and recurrence of benign paroxysmal positional vertigo. However, the data are rather contradictory and require further investigation. Identifying and correcting of metabolic factors will optimize therapy.

scholarly journals Comparison of effectiveness of Cawthorne Cooksey exercise with Brandt Daroff exercise in managing post Epley’s residual dizziness in patients with posterior canal benign paroxysmal positional vertigo

2021 ◽  
Vol 7 (11) ◽  
pp. 1750
Author(s):  
Sunil K. S. Bhadouriya ◽  
Shaili Priyamvada ◽  
Hukam Singh
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Disorder ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Comparison Of Effectiveness ◽  
Peripheral Vertigo ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo.  Vertigo and balance disorders are among the most common symptoms experienced in patients who visit ENT outpatient department.  BPPV is a common vestibular disorder leading to significant morbidity and psychosocial impact. Residual dizziness is a common condition that manifests as persistent disabling imbalance after successful repositioning maneuvers for BPPV.</p><p class="abstract"><strong>Methods: </strong>In this study we analysed and compared the effectiveness of Cawthorne Cooksey Exercise with Brandt Daroff Exercise to treat residual dizziness after successful Epley’s maneuver for posterior canal benign paroxysmal positional vertigo. A total of 30 subjects with residual dizziness after successful Epley’s maneuver for posterior canal BPPV were included in our study, 10 were male and 20 were female. The Group A received the Cawthorne Cooksey exercise post Epley’s maneuver and Group B received the Brandt Daroff exercise post Epley’s maneuver. </p><p class="abstract"><strong>Results:</strong> We conclude that both the groups have significant improvement in their symptoms and balance. This was indicated by the results.  Despite the significant results within the groups, there was no significant difference between the groups, means both exercises showed almost equal improvement in their respective group.</p><p><strong>Conclusions: </strong>This<strong> </strong>study concludes that both Cawthorne Cooksey exercise and Brandt Daroff exercise are helpful in treating residual dizziness after successful Epley’s maneuver in posterior canal BPPV patients. These exercises are safe and able to reduce subjective symptoms and imbalance hence, any of these can be recommended for treating post Epley’s residual dizziness in patients with posterior canal BPPV.  </p>

Characterisation and objective monitoring of balance disorders following head trauma, using videonystagmography

2011 ◽  
Vol 126 (1) ◽  
pp. 26-33 ◽  
Author(s):  
M B Naguib ◽  
Y Madian ◽  
M Refaat ◽  
O Mohsen ◽  
M El Tabakh ◽  
...  
Keyword(s):  
Head Trauma ◽  
Benign Paroxysmal Positional Vertigo ◽  
Injury Severity ◽  
Cohort Analysis ◽  
Severe Trauma ◽  
Early Recovery ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Balance Disorder ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To characterise balance disorders occurring after head trauma, using videonystagmography, and to test the efficiency of videonystagmography as a diagnostic and monitoring tool.Method:Prospective, cohort analysis of 126 head trauma patients managed with vestibular evaluation, monitoring and treatment, in a tertiary referral centre. Analytical parameters included: head injury severity; balance disorder type, severity and time of onset; and patient recovery and outcome.Results:Head trauma was minor in 31.7 per cent, mild in 36.6 per cent, moderate in 19 per cent and severe in 12.7 per cent. Balance disorder symptoms included vertigo in 42.9 per cent, unsteadiness in 15.9 per cent, dizziness in 9.5 per cent and none in 31.7 per cent. Videonystagmographic balance disorder diagnosis type was peripheral vestibular in 23.8 per cent, central in 7.9 per cent, mixed in 12.7 per cent, benign paroxysmal positional vertigo in 4.8 per cent and no findings in 50.8 per cent. Balance disorder was immediate in 47.6 per cent (this included all moderate and severe trauma cases). Benign paroxysmal positional vertigo developed within the first week in two-thirds of cases. More severe trauma cases had longer recovery times. Peripheral, mixed and central balance disorders recovered within the first three months. Early rehabilitation of acute balance disorders led to early recovery regardless of diagnosis.Conclusion:Videonystagmography enables precise, simple, cost-effective monitoring of balance disorders after head trauma, and improves care and outcomes.

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