scholarly journals Benign Paroxysmal Positional Vertigo (BPPV) in COVID-19

2021 ◽  
Vol 11 (3) ◽  
pp. 418-422
Author(s):  
Pasqualina Maria Picciotti ◽  
Giulio Cesare Passali ◽  
Bruno Sergi ◽  
Eugenio De Corso
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Cytopathic Effect ◽  
Semicircular Canals ◽  
Bed Rest ◽  
Clinical History ◽  
Mild Phenotype ◽  
Direct Damage ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Paroxysmal Positional Vertigo

Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining of vertigo. Patients were evaluated at the end of infection with an accurate clinical history, and the investigation of spontaneous, positional and positioning nystagmus. Results: The vestibular findings showed benign paroxysmal positional vertigo (BPPV) in all the patients. Three patients had a mild phenotype of the COVID infection, whereas five subjects were hospitalized for the COVID infection and in three cases intensive care was required. Vestibular evaluation showed an involvement of posterior semicircular canals in five patients and horizontal in three. Three patients were treated with the Epley maneuver, two with Semont, one with Lempert and two with Gufoni maneuvers. Conclusions: We hypothesize that BPPV in COVID-19 infections can be relate to drugs, prolonged bed rest and to direct damage by viral infection on the peripheral vestibular system and in particular on the otolitic membrane due to the cytopathic effect of the virus and to the inflammatory response. Studies on large series of patients are needed to confirm our preliminary observation and to better evaluate the pathophysiological mechanisms underlying BPPV in these patients.

Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo

2012 ◽  
Vol 147 (5) ◽  
pp. 919-924 ◽  
Author(s):  
Seong Jun Choi ◽  
Jong Bin Lee ◽  
Hye Jin Lim ◽  
Hun Yi Park ◽  
Keehyun Park ◽  
...  
Keyword(s):  
Clinical Features ◽  
Benign Paroxysmal Positional Vertigo ◽  
Case Series ◽  
Semicircular Canals ◽  
University Hospital ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Clinical Records ◽  
Secondary Causes ◽  
Paroxysmal Positional Vertigo

Objectives To identify clinical features and causes of recurrent or persistent benign paroxysmal positional vertigo (BPPV) and to analyze the effectiveness of frequently repeated canalith repositioning procedures (CRPs). Study Design Case series with chart review. Setting Academic university hospital. Methods The authors retrospectively reviewed the clinical records of 120 patients who were diagnosed with BPPV at the Dizziness Clinic in Ajou University Hospital, Korea, between 2004 and 2008. “Persistent” and “recurrent” BPPV were respectively defined as BPPV continuing more than 2 weeks and recurring BPPV in the same canals after at least 2 weeks of a symptom-free interval following previous successful treatments. The authors treated patients with frequently repeated CRPs such as the modified Epley maneuver or a barbecue rotation every 2 or 3 days in the outpatient clinic. Results Among 120 patients with BPPV, 93 (77.5%) were typical, 15 (12.5%) were persistent, and 12 (10.0%) were recurrent. Although the most common cause was idiopathic in both recurrent and persistent BPPV, secondary causes, including trauma, were much more common in recurrent and persistent BPPV than in typical BPPV. Typical and recurrent BPPV developed most commonly in the posterior semicircular canals. Persistent BPPV was most commonly detected in the lateral semicircular canals. After frequently repeated CRPs, 91.7% and 86.7% of the patients with recurrent or persistent BPPV, respectively, had resolution of nystagmus and vertigo. Conclusion Recurrent and persistent BPPV are not rare diseases and occur with a higher incidence than expected, especially in patients with secondary causes. However, they can be successfully treated with frequently repeated CRPs.

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 Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akihide Ichimura ◽  
Shigeto Itani
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Head Roll ◽  
The Right ◽  
Upbeat Nystagmus ◽  
Torsional Nystagmus ◽  
Paroxysmal Positional Vertigo

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix–Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.

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 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.

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 Effect of vitamin D levels in benign paroxysmal positional vertigo

2021 ◽  
Author(s):  
Shweta Sawant ◽  
Taranath Nandini ◽  
Rajashree Partabad
Keyword(s):  
Vitamin D ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Vitamin D Supplementation ◽  
High Rate ◽  
Common Cause ◽  
Rehabilitation Therapy ◽  
Positional Vertigo ◽  
Vitamin D Levels ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is a common cause of disabling vertigo with a high rate of recurrence. BPPV is the most common cause of neurotological disorder. It is caused by dislodged otoconia which fall from the utricular macula and float into the semicircular canals there by making them sensitive to gravity. It has been shown that elderly people may suffer from unrecognized, chronic BPPV. Patients with unrecognized BPPV were more likely to have reduced activity of daily living scores, to have sustained a fall in the previous 3 months and to have depression.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 100 patients with clinical diagnosis of BPPV visiting Navodaya medical college and hospital between June 2019 to May 2020 were included in the study.</p><p class="abstract"><strong>Results:</strong> Patients taking both vitamin D supplementation and rehabilitation therapy improved better than patients taking rehabilitation therapy alone.</p><p class="abstract"><strong>Conclusions:</strong> Both rehabilitation therapy and supplementation of vitamin D is helpful in patients with vitamin D deficient BPPV patients.</p>

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.

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