scholarly journals Treatment Results of Geotropic and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo in a Tertiary Dizziness Clinic

2021 ◽  
Vol 12 ◽  
Author(s):  
Britta D. P. J. Maas ◽  
Roeland B. van Leeuwen ◽  
Sylvia Masius-Olthof ◽  
Peter Paul G. van Benthem ◽  
Tjasse D. Bruintjes
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Treatment Protocol ◽  
High Ratio ◽  
Newly Diagnosed ◽  
Treatment Results ◽  
Recurrence Rates ◽  
Horizontal Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Purpose: To determine the effectiveness of our treatment protocol for geotropic and apogeotropic horizontal canal benign paroxysmal positional vertigo (h-BPPV).Methods: We retrospectively evaluated patients with newly diagnosed geotropic and apogeotropic h-BPPV who visited our clinic between July 2017 and December 2019. Patients were treated according to our treatment protocol, which was implemented in 2017. Patients with geotropic h-BPPV were preferably treated with the Gufoni maneuver. In patients with apogeotropic h-BPPV we executed the modified Gufoni maneuver to achieve conversion to the geotropic type. We looked at the number of successful treatments and the number of recurrences within 1 year.Results: We included 102 patients with h-BPPV, 62 (61%) of whom were treated for geotropic h-BPPV. The ratio of apogeotropic to geotropic h-BPPV was 0.65. After the first visit, we observed resolution of horizontal canal BPPV in 71 and 63% of the geotropic and the apogeotropic group, respectively. After the second visit, this percentage increased to 92% for geotropic h-BPPV and 78% for apogeotropic h-BPPV. After 1 year of follow-up we determined a recurrence rate of 32 and 24% for the geotropic and apogeotropic group, respectively.Conclusion: With our treatment protocol we managed to achieve high rates of symptom resolution in the geotropic and apogeotropic type of h-BPPV with acceptable recurrence rates. We observed a relatively high ratio of apogeotropic h-BPPV to geotropic h-BPPV.

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.

Benign paroxysmal positional vertigo of the posterior semicircular canal: efficacy of Santiago treatment protocol, long-term follow up and analysis of recurrence

2012 ◽  
Vol 126 (4) ◽  
pp. 363-371 ◽  
Author(s):  
A Soto-Varela ◽  
M Rossi-Izquierdo ◽  
G Martínez-Capoccioni ◽  
T Labella-Caballero ◽  
S Santos-Pérez
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Treatment Protocol ◽  
First Year ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Long Term Follow Up ◽  
Paroxysmal Positional Vertigo

AbstractObjectives:To evaluate the efficacy of the Santiago treatment protocol for benign paroxysmal positional vertigo of the posterior semicircular canal, to analyse recurrence and to establish prognostic factors.Material and methods:Four hundred and twelve patients with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal were treated with the Semont manoeuvre and, if symptoms did not resolve, successive application of three Epley manoeuvres plus Brandt–Daroff exercises.Results:Symptoms resolved in 404 patients (98.1 per cent); a single Semont manoeuvre was sufficient in 334 (81.2 per cent). Aetiology had no impact on resolution of symptoms or number of manoeuvres required. The estimated likelihood of recurrence was 14 per cent in the first year and 27 per cent after 10 years. The only factor indicating a worse prognosis was recurrence.Conclusion:In unilateral benign paroxysmal positional vertigo of the posterior semicircular canal, the above treatment protocol cured 98 per cent of patients. More than half of recurrences occurred in the first year. None of the analysed factors increased the likelihood of recurrence.

scholarly journals Treatment of Horizontal Canal Benign Paroxysmal Positional Vertigo: A New Rehabilitation Technique

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
D. Testa ◽  
G. Castaldo ◽  
C. De Santis ◽  
A. Trusio ◽  
G. Motta
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Treatment Session ◽  
Horizontal Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The aim of this study was to evaluate the effectiveness of a new technical variant applied to the Gufoni's manoeuvre, in the treatment of horizontal canal benign paroxysmal positional vertigo (HSC-BPPV). 87 patients with BPPV of HSC (55 women and 32 men), aged between 21 and 80 years, were randomized either to modified Gufoni's manoeuvre or to the Gufoni's manoeuvre. 93% of patients treated with modified Gufoni's manoeuvre was cured after the first treatment session, of which only 2% had a conversion into PSC-BPPV, while the Gufoni's manoeuvre led to a symptoms resolution in 88% of cases, of which 16% had a conversion into PSC-BPPV. Therefore, the modified Gufoni's manoeuvre shows the same effectiveness in the resolution of symptoms of Gufoni's manoeuvre, but it appears more effective than the latter to reduce the percentage of conversion of the HSC-BPPV into PSC-BPPV (χ2=6.13,P=0.047).

Argon laser irradiation of the semicircular canal in two patients with benign paroxysmal positional vertigo

2002 ◽  
Vol 116 (9) ◽  
pp. 723-725 ◽  
Author(s):  
Yasuya Nomura
Keyword(s):  
Laser Irradiation ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Argon Laser ◽  
Laser Device ◽  
Positional Vertigo ◽  
Long Term Follow Up ◽  
Paroxysmal Positional Vertigo

The results of long-term follow-up after surgical treatment of two patients with intractable benign paroxysmal positional vertigo are reported. Argon laser irradiation of the blue-lined posterior and lateral semicircular canals in one patient, and of only the posterior canal in the other was performed seven and six years ago, respectively. Argon laser irradiation was carried out 10 times in succession three mm along the canal to occlude it. The power applied each time was 1.5.W on the dial of the laser device for 0.5.sec. Relief of vertigo was noted on the second post-irradiation day. There has been no recurrence of vertigo in these patients.

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.

scholarly journals Serum levels of superoxide dismutases in patients with benign paroxysmal positional vertigo

2020 ◽  
Vol 40 (5) ◽  
Author(s):  
Jing Li ◽  
Rui Wu ◽  
Bin Xia ◽  
Xinhua Wang ◽  
Mengzhou Xue
Keyword(s):  
Serum Level ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Serum Levels ◽  
Superoxide Dismutases ◽  
Binary Logistic Regression Analysis ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Abstract Objective: To investigate the possible role of superoxide dismutases (SODs) in the development of benign paroxysmal positional vertigo (BPPV) and recurrence events in a 1-year follow-up study. Methods: This was a prospective one-center study. A total of 204 patients with BPPV and 120 age-and sex matched healthy subjects were included. The levels of SOD between patients and control cases were compared. The levels of SOD between posterior semicircular canal (PSC) and horizontal semicircular canal (HSC) were also compared. In the 1-year follow-up, recurrence events were confirmed. The influence of SOD levels on BPPV and recurrent BPPV were performed by binary logistic regression analysis. Results: The serum levels of SOD in patients with BPPV were lower than in those control cases (P&lt;0.001). Levels of SOD did not differ in patients with PSC and HSC (P=0.42). As a categorical variable, for per interquartile range (IQR) increment of serum level of SOD, the unadjusted and adjusted risks of BPPV would be decreased by 72% (with the odds ratio [OR] of 0.28 [95% confidence interval (CI): 0.21–0.37], P&lt;0.001) and 43% (0.57 [0.42–0.69], P&lt;0.001), respectively. Recurrent attacks of BPPV were reported in 50 patients (24.5%). Patients with recurrent BPPV had lower levels of SOD than in patients without (P&lt;0.001). For per IQR increment of serum level of SOD, the unadjusted and adjusted risks of BPPV would be decreased by 51% (with the OR of 0.49 [95% CI: 0.36–0.68], P&lt;0.001) and 24% (0.76 [0.60–0.83], P&lt;0.001), respectively. Conclusion: Reduced serum levels of SOD were associated with higher risk of BPPV and BPPV recurrence events.

scholarly journals Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026936
Author(s):  
Chiao-Lin Hsu ◽  
Shih-Jen Tsai ◽  
Cheng-Che Shen ◽  
Ti Lu ◽  
Yao-Min Hung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lupus Erythematosus ◽  
Depressive Disorders ◽  
Benign Paroxysmal Positional Vertigo ◽  
Observation Time ◽  
Research Database ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Paroxysmal Positional Vertigo

ObjectiveThe association between depression and benign paroxysmal positional vertigo (BPPV) remains debated. This study aimed to investigate the risk of BPPV in patients with depressive disorders.DesignLongitudinal nationwide cohort study.SettingNational health insurance research database in Taiwan.ParticipantsWe enrolled 10 297 patients diagnosed with depressive disorders between 2000 and 2009 and compared them to 41 188 selected control patients who had never been diagnosed with depressive disorders (at a 1:4 ratio matched by age, sex and index date) in relation to the risk of developing BPPV.MethodsThe follow-up period was defined as the time from the initial diagnosis of depressive disorders to the date of BPPV, censoring or 31 December 2009. Cox proportional hazard regression analysis was used to investigate the risk of BPPV by sex, age and comorbidities, with HRs and 95% CIs.ResultsDuring the 9-year follow-up period, 44 (0.59 per 1000 person-years) patients with depressive disorders and 99 (0.33 per 1000 person-years) control patients were diagnosed with BPPV. The incidence rate ratio of BPPV among both cohorts calculating from events of BPPV per 1000 person-years of observation time was 1.79 (95% CI 1.23 to 2.58, p=0.002). Following adjustments for age, sex and comorbidities, patients with depressive disorders were 1.55 times more likely to develop BPPV (95% CI 1.08 to 2.23, p=0.019) as compared with control patients. In addition, hyperthyroidism (HR=3.75, 95% CI 1.67–8.42, p=0.001) and systemic lupus erythematosus (SLE) (HR=3.47, 95% CI 1.07 to 11.22, p=0.038) were potential risk factors for developing BPPV in patients with depressive disorders.ConclusionsPatients with depressive disorders may have an increased risk of developing BPPV, especially those who have hyperthyroidism and SLE.

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