scholarly journals Benign Paroxysmal Positional Vertigo: Comparison of Idiopathic BPPV and BPPV Secondary to Vestibular Neuritis

2019 ◽  
pp. 014556131987123 ◽  
Author(s):  
Bilge Türk ◽  
Meltem Akpinar ◽  
Kerem Sami Kaya ◽  
Arzu Yasemin Korkut ◽  
Suat Turgut
Keyword(s):  
Clinical Features ◽  
Clinical Data ◽  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Vestibular Neuritis ◽  
Care Hospital ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The aim of this study was to reveal clinical features of benign paroxysmal positional vertigo (BPPV) through comparing idiopathic BPPV and BPPV secondary to vestibular neuritis (VN). The clinical data of the 189 BPPV patients admitted to our tertiary care hospital including otolaryngological, audiological, vestibular, neurological, and radiological evaluations were reviewed. Patients diagnosed with idiopathic BPPV (n = 145) and BPPV secondary to VN (n = 44) were grouped as I and II, respectively. The clinical data of 2 groups were compared. The findings of the study showed that the patients with secondary BPPV due to VN are much younger, have symptoms of only posterior semicircular canal involvement, and require more treatments compared to patients with idiopathic BPPV. The clinical features of patients with BPPV secondary to VN and idiopathic BPPV differ on several aspects. More extensive studies are needed to investigate the underlying etiology in patients with BPPV encountered after VN.

scholarly journals Effectiveness of Semont maneuver in the treatment of benign paroxysmal positional vertigo: an institutional study

2020 ◽  
Vol 7 (1) ◽  
pp. 27
Author(s):  
Swapna U. P. ◽  
Smitha B. ◽  
Salil Kumar K.
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care ◽  
Head Movements ◽  
Treatment Modalities ◽  
Controlled Study ◽  
Care Hospital ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. In this condition, the vertigo is precipitated by certain head movements. BPPV is diagnosed by Dix-Hallpike positional test. Various repositioning maneuvers and treatment modalities exist for the management of this condition. Semont maneuver is a simple procedure for the treatment of posterior semicircular canal BPPV.</p><p><strong>Methods: </strong>This non randomized controlled study was conducted in the ENT Department of a tertiary care hospital at Thiruvananthapuram over a period of one year. Hundred patients with posterior semicircular canal BPPV were included in the study.  Fifty patients treated with Semont maneuver were compared with 50 patients who were treated with betahistine 16 mg three times daily.  Outcomes were measured by relief of vertigo and negative Dix- Hallpike positional test during follow up examination.</p><p><strong>Results: </strong>The most common age group affected by BPPV was 50-60 years.  Right side was more affected than the left. There was a female preponderance. 84% patients treated with Semont maneuver were cured at the end of the first week and 90% at the end of the second week. The percentage of patients cured with betahistine were 48% at the end of first week and 56% at the end of second week. </p><p><strong>Conclusions: </strong>The Semont maneuver was very effective in the treatment of BPPV. It helps to reduce the long-term use of medicines in our population.</p>

scholarly journals Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

2021 ◽  
pp. 188-194
Author(s):  
Celastina Synthia ◽  
. Rameshwar
Keyword(s):  
Head Injury ◽  
Traffic Accidents ◽  
Benign Paroxysmal Positional Vertigo ◽  
Road Traffic ◽  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Traumatic brain injury is a common secondary cause of  Benign Paroxysmal  Positional Vertigo(BPPV). Objective: To determine the incidence and clinical profile of patients with BPPV in mild and moderate head injury. Materials and Methods: A prospective observational study done in patients admitted with  mild and moderate head injury who developed BPPV from January 2020 to March 2020 in a tertiary care hospital of  South India. Demographic and clinical parameters were noted and were treated with canalith repositioning procedures. Results: Among 42 patients admitted with mild and moderate head injury, 9(21.4%) were diagnosed with BPPV in the follow up. The male female ratio was 2.5:1. The mean age was 44 ±21.4years.Two wheeler accidents contributed to nearly half of (55.6%) traumatic BPPV. Posterior canal was commonly involved in 7(77.8%) followed by horizontal in 2 (22.2%).The type of head injury was mild in 7 (77.8%) and moderate in 2 (22.2%) in traumatic BPPV patients. 5 (55.6%) patients with BPPV had abnormal findings in neuroimaging. 4 (44.4%) patients developed recurrent BPPV in our cohort. Conclusion: The incidence of traumatic BPPV was 21.4% in our study. Road traffic accidents due to two wheeler accidents were the common mode of head trauma. Posterior canal was commonly involved in three fourth of cases. Recurrence of vertigo was documented in 4 (44.4%).

scholarly journals P014: Does a positive Dix-Hallpike rule out a central cause of vertigo?

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S68
Author(s):  
O. Bodunde ◽  
A. Regis ◽  
R. LePage ◽  
Z. Turgeon ◽  
R. Ohle
Keyword(s):  
Risk Factors ◽  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care ◽  
Cerebral Haemorrhage ◽  
Neurological Deficits ◽  
Posterior Semicircular Canal ◽  
Diagnostic Codes ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo ◽  
Rule Out

Introduction: Dizziness is a common presentation in emergency departments (ED), accounting for 2-3% of all visits. The majority are due to benign causes the most common of which is benign paroxysmal positional vertigo (BPPV). The Dix-Hallpike maneuver is used to diagnose BPPV with an affected posterior semicircular canal. A positive Dix-Hallpike exam should lead physicians to exclude central causes for a patient's symptoms and confirm no need for further imaging. The purpose of our study was to verify the accuracy of the Dix-Hallpike maneuver for ruling out a central cause of dizziness. Methods: We performed a medical records review of adult patients with dizziness/vertigo presenting to a tertiary care ED (September 2014 and March 2018). We included those with a suspicion for BPPV and underwent a Dix-Hallpike maneuver. We excluded patients who presented with dizziness for longer than two weeks, syncope, systolic hypotension &lt;90 or a GCS &lt;15. Individual patient data were linked with the Institute of Clinical Evaluation Science (ICES) database. Our outcome was a central cause defined as: ischemic stroke (IS), brain tumour, intra cerebral haemorrhage (ICH), or multiple sclerosis (MS) diagnosed on either neurology assessment, computed tomography, magnetic resonance imaging, or diagnostic codes related to central causes found within ICES. Results: 3109 patients were identified of these 469 patients underwent a Dix-Hallpike manoeuvre. Central causes of dizziness accounted for 1.1% of all diagnoses. Probability of a central cause for dizziness in those with a positive Dix-Hallpike was 1.3%(3/229). Only 85(18.1%) patients were appropriate for the Dix-Hallpike(intermittent, position-evoked vertigo without any neurological deficits). In appropriate patients the prevalence of central cause of dizziness was 3%(1/31). This patient had &gt; 3 risk factors for stroke (age &gt; 65, hypertension, diabetes, ischemic heart disease). A positive Dix-Hallpike in appropriate patients with &lt;3 risk factors for stroke was 100% (95%CI 88.8% -100%) sensitive in ruling out a central cause for dizziness. Conclusion: The Dix-Hallpike manoeuvre is performed on a large number of inappropriate patients. When performed on appropriate patients with &lt;3 risk factors for stroke a positive Dix-Hallpike can rule out a central cause of vertigo. Educating physicians as to the appropriate patient population could reduce unnecessary imaging and improve diagnostic accuracy.

scholarly journals Behavior of the posterior semicircular canal after Dix-Hallpike maneuver

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Francisco Carlos Zuma e Maia ◽  
Pedro Luiz Mangabeira Albernaz ◽  
Renato Valério Cal
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Biomechanical Model ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix- Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients’ age.

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.

scholarly journals The efficacy of Epley and Semont maneuvers in posterior semicircular canal benign paroxysmal positional vertigo treatment: A short-term comparative study

2021 ◽  
Vol 9 (3) ◽  
pp. 75-80
Author(s):  
Mustafa Caner Kesimli
Keyword(s):  
Comparative Study ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Short Term ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
The One ◽  
Paroxysmal Positional Vertigo

OBJECTIVE: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. METHODS: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. RESULTS: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and one-month follow-ups (p=0.002, p<0.001, p=0.001, respectively). CONCLUSION: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigo.

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