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.

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 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.

Treatment of Objective and Subjective Benign Paroxysmal Positional Vertigo

2013 ◽  
Vol 24 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Alexandra C. Huebner ◽  
Susan R. Lytle ◽  
Steven M. Doettl ◽  
Patrick N. Plyler ◽  
James T. Thelin
Keyword(s):  
Repeated Measures ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Subjective Report ◽  
Repeated Measures Design ◽  
Positional Vertigo ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Before And After ◽  
Paroxysmal Positional Vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults and is a result of otolithic particles or debris that become free floating within a semicircular canal or adhere to the cupula. Characteristics of BPPV include brief episodes of latent onset vertigo that occur with changes in head position, transient rotary nystagmus beating toward the dependent ear, and reversed nystagmus upon sitting up. Both the vertigo and nystagmus fatigue quickly while maintaining the same head position. The BPPV may be classified as objective or subjective. Objective BPPV presents all the aforementioned symptoms whereas subjective BPPV presents all the symptoms without nystagmus. The accepted method of treatment for objective BPPV is canalith repositioning maneuvers (CRM); however, CRM are not traditionally used as the method of treatment for cases of subjective BPPV. Purpose: The purpose of the study was to determine if the subjective report of dizziness using the Dizziness Handicap Inventory (DHI) was different in patients with objective and subjective BPPV and to determine if the two groups showed similar improvements in perceived dizziness handicap following CRM treatment. Research Design: The present study utilized a retrospective, repeated measures design. Study Sample: Sixty-three adults with BPPV that were given the DHI both before and after CRM treatment. Data Collection and Analysis: Pre and post DHI results were analyzed for participants with objective versus subjective BPPV. A five-question DHI subscale was also analyzed between the groups. Results: A significant difference was noted between initial and posttreatment DHI scores for patients in both the subjective and objective groups when using the full-scale and subscale DHI. No significant difference was noted between groups for their initial or posttreatment DHI scores. The two groups also did not differ significantly in their initial or posttreatment DHI subscale scores. Conclusions: The results of the study indicated that individuals with both objective and subjective BPPV demonstrated significant improvement in DHI scores following CRM treatment. Additionally, there was no difference in DHI improvement for the subjective versus objective group suggesting CRM are effective for both subjective BPPV and objective BPPV. This improvement in DHI scores was also noted in the five-question DHI subscale with no significant difference noted between groups. These findings combined with previous studies suggest the presence or absence of nystagmus during Dix-Hallpike maneuvers is not related to the effectiveness of treatment using CRM.

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.

scholarly journals Efficacy of the Canalith Repositioning Procedure in Benign Paroxysmal

2016 ◽  
Vol 27 (2) ◽  
pp. 23-27
Author(s):  
Abul Mansur Md Rezaul Karim ◽  
Md Hasanuzzaman ◽  
Mohammed Abu Yusuf Chowdhury ◽  
Md Abu Tayeb
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Movements ◽  
Control Treatment ◽  
College Hospital ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Group A ◽  
Canalith Repositioning Procedure ◽  
Group B ◽  
Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is paroxysms of vertigo occurring with certain head movements, typically looking up or turning over in bed comprising about 20% of Dizziness cases. This study was carried out to evaluate the Efficacy of canalith repositioning procedure(CRP) in BPPV. A randomized clinical trial including 80 patients with BPPV was performed Medicine & Neurology Outpatient Department, Chittagong Medical College Hospital. The patients were randomly divided into two groups. Group A treated by anti-vertigo drug and CRP, Group B treated by anti-vertigo drug alone. All patients were followed up in hospital at one week after & 4 weeks. The rates of effectiveness of CRP treatment and the control treatment for were 86.8% and 59.4%, respectively. There was a significant difference (27.4%) in the outcomes of the CRP & control groups (P <.05). Mean total drug use for the group A was 10 ± 1, whereas it was 30 ± 1.5 for group B, mean difference = 20 (P < .001, highly Significant). At 4 Weeks, subjective improvement and symptom free occurred in 94.7% patients in group A and 73% patients in group B (difference21.7%). Complications in the CRP group were observed in 10.6% of the patients. This study demonstrated that canalith repositioning procedure (CRP) was effective in the treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery & low drug dependence. Complications of CRP were limited to 10.6% of patients.Medicine Today 2015 Vol.27(2): 23-27

The Efficacy of Vestibular Rehabilitation in Patients with Benign Paroxysmal Positional Vertigo

2014 ◽  
Vol 151 (5) ◽  
pp. 740-745 ◽  
Author(s):  
Ellis S. van der Scheer-Horst ◽  
Peter Paul G. van Benthem ◽  
Tjasse D. Bruintjes ◽  
Roeland B. van Leeuwen ◽  
Hester J. van der Zaag-Loonen
Keyword(s):  
English Language ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Positional Vertigo ◽  
Central Register ◽  
Significant Difference ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Objective To systematically review the evidence on the effectiveness of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. Data Sources A literature search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE databases. Review Methods A comprehensive search was performed up to July 2013. Two authors independently scanned the search results to identify randomized controlled trials of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies were methodologically assessed using the Cochrane risk of bias tool. Primary outcome was the effect on vertigo attacks and balance. Results Of 76 identified trials, only 2 trials fulfilled our inclusion criteria and were included in this review, involving 106 patients. One study was methodologically weak, the other strong. The studies differed in type of intervention, type of outcome, and follow-up time. Both studies reported no significant difference in the vertigo intensity between groups. A small effect was found on balance. Conclusion Two level II studies in benign paroxysmal positional vertigo showed no effect of vestibular rehabilitation in addition to a canalith repositioning maneuver on vertigo intensity and a small, beneficial effect on balance. We therefore conclude that there is no evidence for an effect of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.

scholarly journals Physical Therapy for Benign Positional Vertigo of Posterior Canal: The Role of Alternated Epley and Semont Maneuvers

2021 ◽  
pp. 014556132098018
Author(s):  
Andrea Lovato ◽  
Gino Marioni ◽  
Daniele Monzani ◽  
Giacomo Rossettini ◽  
Elisabetta Genovese ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Dizziness Handicap Inventory ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Objective: To investigate if alternated Epley (EP) and Semont (ST) maneuvers could be more effective than repetition of the same in benign paroxysmal positional vertigo of posterior semicircular canal (pBPPV). Design: We retrospectively reviewed the outcome of pBPPV patients treated with a second maneuver for the persistence of positional nystagmus. Study Sample: Forty-seven patients underwent 2 STs, 64 with 2 EPs, and 71 EPs followed by ST. Videonystagmography and Dizziness Handicap Inventory (DHI) questionnaire were performed. Results: Absence of positional nystagmus was achieved after 2 maneuvers in 136 patients with pBPPV: 65.9% in the ST group, 70.3% in the EP group, and 84.5% in the EP-ST group. Alternated EP and ST were significantly more effective than repeated ST ( P = .03), while we found no significant difference when compared with repeated EP ( P = .07). At 1-month follow-up, 12 patients showed persistent positional nystagmus without difference between groups. After 1 month, the 46 patients with negative outcome had significantly higher DHI values ( P = .01) than other 136 patients with pBPPV. Conclusions: Alternated EP and ST seemed more effective than repeating the same maneuver in treating pBPPV, and this should be confirmed in prospective clinical studies. Resolution of nystagmus after maneuvers was fundamental to reduce handicap deriving from dizziness as reported in DHI.

scholarly journals Objective findings in patients with multi-canal benign paroxysmal positional vertigo

2021 ◽  
pp. 014556132110666
Author(s):  
Yanhan Zhu ◽  
Xiaoming He ◽  
Mei Hu ◽  
Chun Mao ◽  
Zheng Liu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Benign Paroxysmal Positional Vertigo ◽  
Disease Onset ◽  
Vestibular Disorder ◽  
Female Ratio ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Peripheral Vestibular Disorder ◽  
Male To Female ◽  
Paroxysmal Positional Vertigo

Objective The study aimed to investigate the clinical characteristics of patients with multi-canal benign paroxysmal positional vertigo (MC-BPPV). Methods We performed a retrospective analysis of 927 patients with BPPV who were admitted to our hospital between January 1, 2016 and December 31, 2019. The clinical data of all patients were collected. The Dix-Hallpike, straight head-hanging, and supine Roll tests were performed in all patients. The nystagmus was recorded using videonystagmography. The clinical characteristics of patients with MC-BPPV and single canal BPPV (SC-BPPV) was analyzed and compared. Results Among 927 patients included, 49 (5.29%) patients had MC-BPPV, 878 (94.71%) patients had SC-BPPV. There were significant differences in the male to female ratio (1:3.90 vs 1:1.81, P < .05), mean age (62.47±12.51 vs 59.04±13.72, P < .05), as well as the ratio of cupulolithiasis to canalithiasis (1:1.45 vs 1:4.78, P < .01) between patients with MC-BPPV and SC-BPPV. The frequency of involvement of PC, HC, and AC were involved for 66 (67.35%), 23 (23.47%), and 9 (9.18%) times, respectively, in patients with MC-BPPV, which were involved in 581 (66.17%), 281 (32.0%), and 16 (1.82%) patients, respectively, in patients with SC-BPPV. No significant difference was found in the frequency of involvement of PC and HC between patients with MC-BPPV and SC-BPPV, while there was significant difference in the frequency of AC involvement between 2 groups ( P < .01). Ipsilateral PC-HC-BPPV (n = 18) and bilateral PC-BPPV (n=19) were the most common among patients with MC-BPPV. Twenty-six (53.06%) patients had ipsilateral MC-BPPV, 23 (46.94%) had bilateral MC-BPPV. Of the 26 patients with ipsilateral MC-BPPV, 7 patients combined with unilateral peripheral vestibular disorder. Conclusion Patients with MC-BPPV had a significantly older mean age at disease onset and a higher proportion of females compared with patients with SC-BPPV. Cupulolithiasis was more common in MC-BPPV. AC involvement was also much more common in MC-BPPV than in SC-BPPV.

scholarly journals The Association Between Serum Vitamin D Levels and Benign Paroxysmal Positional Vertigo

2021 ◽  
pp. 014556132110085
Author(s):  
Kanokporn Sarsitthithum ◽  
Tosapohn Wisupagan ◽  
Sivaporn Kiatthanabumrung ◽  
Chanchai Jariengprasert
Keyword(s):  
Vitamin D ◽  
Benign Paroxysmal Positional Vertigo ◽  
Serum Vitamin ◽  
Control Group ◽  
P Value ◽  
Serum Vitamin D ◽  
Positional Vertigo ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Objective: This study aimed to evaluate the association between serum vitamin D levels and benign paroxysmal positional vertigo (BPPV). Participants and Methods: This prospective study consisted of 137 participants. There were 69 participants in the BPPV group compared with 68 healthy participants. Blood samples from both groups were collected from all participants to assess serum vitamin D levels. Results: No significant difference in demographic data between BPPV and control groups. The results showed that the mean serum vitamin D levels in the BPPV group was lower than that of the control group ( P value = .001). Among BPPV participants, there was no statistically significant difference between mean serum vitamin D levels of participants with recurrent BPPV, and that of newly diagnosed BPPV participants ( P value = .313). Conclusion: A statistically significant association between lower mean serum vitamin D levels in the BPPV group compared with that of the control group. Therefore, low serum vitamin D levels may be one of the risk factors for BPPV.

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