scholarly journals Self-Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Preliminary Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhuangqin Gan ◽  
Shiling Zhou ◽  
Hui Yang ◽  
Feng He ◽  
Dong Wei ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Benign Paroxysmal Positional Vertigo ◽  
Residual Symptoms ◽  
Resolution Rate ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Epley Maneuver ◽  
Preliminary Study ◽  
Paroxysmal Positional Vertigo

Objectives: The purpose of this study is to investigate a modified Epley maneuver for self-treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV).Methods: The study recruited 155 patients with PC-BPPV. All patients were randomized into the Epley maneuver group (n = 77) and modified Epley maneuver group (n = 78). We analyzed the resolution rate (1 day and 1 week), residual symptoms after the maneuver, and adverse effects.Results: It was found that the modified Epley maneuver group had a higher resolution rate than that of the Epley maneuver group in the treatment of PC-BPPV after 1 day of the initial maneuver (p < 0.05). However, there was no difference in resolution rate between the Epley maneuver group and the modified Epley maneuver group in resolution rate after 1 week of the initial maneuver (p > 0.05). The modified Epley maneuver group had fewer residual symptoms than that of the Epley maneuver group 1 week after treatment of PC-BPPV (p < 0.05). Significant improvements were also observed in average DHI scores in patients who underwent the modified Epley maneuver compared to the Epley maneuver (p < 0.05). There was no significant difference in adverse effects between the two groups (p > 0.05).Conclusions: The modified Epley maneuver has a satisfactory therapeutic efficacy with less residual symptoms and could be recommended as a self-treatment for patients with PC-BPPV.

The Impact of Betahistine versus Dimenhydrinate in the Resolution of Residual Dizziness in Patients with Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial

2019 ◽  
Vol 129 (5) ◽  
pp. 434-440
Author(s):  
Mir Mohammad Jalali ◽  
Hooshang Gerami ◽  
Alia Saberi ◽  
Siavash Razaghi
Keyword(s):  
Clinical Trial ◽  
Logistic Regression ◽  
Randomized Clinical Trial ◽  
Benign Paroxysmal Positional Vertigo ◽  
Binary Logistic Regression Analysis ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Epley Maneuver ◽  
The Impact ◽  
Paroxysmal Positional Vertigo

Objectives: The aim of this study was to compare the effects of betahistine with dimenhydrinate on the resolution of residual dizziness (RD) of patients with benign paroxysmal positional vertigo (BPPV) after successful Epley maneuver. Methods: In this double-blind, randomized clinical trial, patients with posterior semicircular canal type of BPPV were included. After execution of the Epley maneuver, patients were assigned randomly to one group for 1 week: betahistine, dimenhydrinate or placebo. The primary outcomes were scores of the Dizziness Handicap Inventory (DHI) and the modified Berg balance scale (mBBS). All patients were asked to describe the characteristics of their subjective residual symptoms. Binary logistic regression analysis was performed to examine the predictors of improved RD. All analyses were conducted using SPSS 19.0. Results: In total, 117 patients (age range: 20-65 years) participated in this study. After the Epley maneuver, 88 participants had RD. After the intervention, 38 patients exhibited an improved RD. Less than 50% of participants in the three groups showed mild to moderate dizziness handicap. However, there was no significant difference between mBBS scores of groups before or after the intervention. Logistic regression was shown that patients with receiving betahistine were 3.18 times more likely to have no RD than the placebo group. Increasing age was associated with a decreased likelihood of improving RD ( P = .05). Conclusion: The analysis of data showed that the use of betahistine had more effect on improving RD symptoms. We recommended future studies using objective indicators of residual dizziness.

Characteristics of Benign Paroxysmal Positional Vertigo Following an Earthquake

2021 ◽  
pp. 000348942199691
Author(s):  
Muhammed Gazi Yildiz ◽  
Nagihan Bilal ◽  
Irfan Kara ◽  
Saime Sagiroglu ◽  
Israfil Orhan ◽  
...  
Keyword(s):  
Outpatient Clinic ◽  
Benign Paroxysmal Positional Vertigo ◽  
Depression Scale ◽  
Post Treatment ◽  
Treatment Modalities ◽  
Residual Symptoms ◽  
Positional Vertigo ◽  
Number Of Patients ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is a commonly encountered peripheral vestibular disorder. People exposed to massive earthquakes experience intense and long-term problem associated with dizziness. The purpose of our study is to investigate this relationship and to demonstrate the efficacy of the treatment modalities used in the management of patients with post-earthquake dizziness. Methodology: The study was carried out by examining the retrospective records of patients who presented with dizziness to the otorhinolaryngological outpatient unit before and after the Elazig earthquake that occurred on 24th Jan 2020. Parameters evaluated include patients’ age and gender, onset of dizziness, accompanying symptoms and comorbidities, videonystagmography (VNG) findings, pre- and post-treatment Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS). Results: The number of patients who presented with dizziness to our outpatient clinic after the earthquake and were included in our study totaled 84. The number of patients who visited the outpatient clinic before the earthquake was identified to be 75. In the earthquake related group, while there was a statistically significant difference between residual symptoms (RS) and the need for repetitive repositioning maneuvers, there was no statistically significant difference detected for age, gender, and comorbidities. Also, no statistically significant difference was found in the pre- and post-treatment assessments of VAS, DHI, and HADS median values in the earthquake group. Conclusion: There was a remarkable increase in the number of patients presenting with dizziness in the early post-earthquake period. Management of these patients may differ from the classic BPPV. Residual symptoms appearing after performing repositioning maneuvers can be more commonly seen among these patients.

scholarly journals Recovery of Regular Daily Physical Activities Prevents Residual Dizziness after Canalith Repositioning Procedures

2022 ◽  
Vol 19 (1) ◽  
pp. 490
Author(s):  
Salvatore Martellucci ◽  
Andrea Stolfa ◽  
Andrea Castellucci ◽  
Giulio Pagliuca ◽  
Veronica Clemenzi ◽  
...  
Keyword(s):  
Daily Activity ◽  
Benign Paroxysmal Positional Vertigo ◽  
Physical Activities ◽  
University Hospital ◽  
Residual Symptoms ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Observational Cohort ◽  
Daily Physical Activities ◽  
Paroxysmal Positional Vertigo

Objective: Residual dizziness is a disorder of unknown pathophysiology, which may occur after repositioning procedures for benign paroxysmal positional vertigo. This study evaluates the relationship between regular daily physical activity and the development of residual dizziness after treatment for benign paroxysmal positional vertigo. Study Design: Prospective observational cohort study. Setting: Academic university hospital. Methods: Seventy-one patients admitted with benign paroxysmal positional vertigo involving the posterior semicircular canal were managed with Epley’s procedure. Three days after successful treatment, the patients underwent a telephone interview to investigate vertigo relapse. If the patients no longer complained of vertigo, they were asked about symptoms consistent with residual dizziness. Subsequently, they were asked about the recovery of physical activities they regularly performed prior to the onset of vertigo. Results: Sixty-nine patients (age: 57.79 ± 15.05) were enrolled: five (7.24%) reported vertigo relapse whereas twenty-one of sixty-four non-relapsed patients (32.81%) reported residual dizziness. A significant difference in the incidence of residual dizziness was observed considering the patients’ age (p = 0.0003). Of the non-relapsed patients, 46 (71.88%) recovered their regular dynamic daily activities after treatment and 9 (19.57%) reported residual dizziness, while 12 of the 18 patients (66.67%) who did not resume daily activity reported residual symptoms (p = 0.0003). A logistic regression analysis showed a significant association between daily activity resumption and lack of residual dizziness (OR: 14.01, 95% CI limits 3.14–62.47; p = 0.001). Conclusions: Regardless of age, the resumption of regular daily physical activities is associated with a lack of residual dizziness.

Rapid Systematic Review of the Epley Maneuver for Treating Posterior Canal Benign Paroxysmal Positional Vertigo

2014 ◽  
Vol 150 (6) ◽  
pp. 925-932 ◽  
Author(s):  
Jeroen G. van Duijn ◽  
Liz M. Isfordink ◽  
Jenny A. Nij Bijvank ◽  
Carlijne W. Stapper ◽  
Annelies J. van Vuren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Paroxysmal Positional Vertigo

The Additional Effect of Vestibular Rehabilitation Therapy on Residual Dizziness After Successful Modified Epley Procedure for Posterior Canal Benign Paroxysmal Positional Vertigo

2021 ◽  
pp. 1-9
Author(s):  
Maryam Heydari ◽  
Mohsen Ahadi ◽  
Bahram Jalaei ◽  
Mohammad Maarefvand ◽  
Hossein Talebi
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Short Form ◽  
Vestibular Rehabilitation ◽  
Control Group ◽  
Symptom Scale ◽  
Posterior Canal ◽  
Rehabilitation Therapy ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Purpose The aim of the study was to evaluate the additional effect of vestibular rehabilitation therapy (VRT) compared with the modified Epley procedure alone on residual dizziness after a successful modified Epley procedure in patients with posterior canal benign paroxysmal positional vertigo (BPPV). Method In this cross-sectional analytical comparative study, 47 patients (35 women and 12 men) aged 18–80 years with posterior canal BPPV were randomly assigned to one of two following groups: the control group, who received the modified Epley procedure only, and the VRT group, who received the modified Epley procedure plus vestibular rehabilitation for 4 weeks. Outcome measures, including the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale–Long Version (VSS-L), and the Vertigo Symptom Scale–Short Form (VSS-SF), were conducted on the same session before initial therapy (T1), at 48 hr later (T2), and at 4 weeks later (T3). Presence or absence of residual dizziness was evaluated at T2. Results Residual dizziness was found in 20 (42.6%) patients after a successful modified Epley procedure. There was no statistically significant difference between the mean DHI, VSS-L, and VSS-SF scores at T1, T2, and T3 in patients who manifested with residual dizziness and those without residual dizziness in both groups. The average DHI, VSS-L, and VSS-SF score reduced during the time in both groups. These results were demonstrated that the VRT group and the control group have similar reductions in symptoms after treatment with the VRT plus modified Epley procedure and the modified Epley procedure only, respectively. Conclusions Residual dizziness is a common condition after a successful modified Epley procedure for BPPV. The VRT plus modified Epley procedure is as effective as modified Epley procedure alone in the management of residual dizziness. Further studies with supervised and customized VRT and longer follow-up periods are needed. Supplemental Material https://doi.org/10.23641/asha.14825508

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>

Combined Horizontal and Posterior Canal Benign Paroxysmal Positional Vertigo in Three Patients with Head Trauma

2005 ◽  
Vol 114 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Pierre Bertholon ◽  
Larbi Chelikh ◽  
Andrei P. Timoshenko ◽  
Stéphane Tringali ◽  
Christian Martin
Keyword(s):  
Head Trauma ◽  
Benign Paroxysmal Positional Vertigo ◽  
Trauma Patients ◽  
Postconcussion Syndrome ◽  
Horizontal Canal ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Lateral Head ◽  
Paroxysmal Positional Vertigo

We report 3 patients who complained of positional vertigo shortly after head trauma. Positional maneuvers performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position with the head raised 30°) revealed a complex positional nystagmus that could only be interpreted as the result of combined PC and HC benign paroxysmal positional vertigo (BPPV). Two patients had a right PC BPPV and an ageotropic HC BPPV, and 1 patient had a bilateral PC BPPV and a left geotropic HC BPPV. All 3 patients were rapidly free of vertigo after the PC BPPV was cured by the Epley maneuver and the geotropic HC BPPV was cured by the Vannucchi method. The ageotropic HC BPPV resolved spontaneously. Neuroimaging (brain computed tomography and/or magnetic resonance imaging scans) findings were normal in all 3 patients. From a physiopathological viewpoint, it is easy to conceive that head trauma could throw otoconial debris into different canals of each labyrinth and be responsible for these combined forms of BPPV. Consequently, in trauma patients with vertigo, it is mandatory to perform the Dix-Hallpike maneuver, as well as supine lateral head turns, in order to diagnose PC BPPV, HC BPPV, or the association of both. Early diagnosis and treatment of BPPV may help to reduce the postconcussion syndrome.

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