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.

scholarly journals Comparision of Video Head Impulse Test Findings Before and After Therapy Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo

2021 ◽  
Author(s):  
ERCAN KARABABA ◽  
Hacı Hüseyin DERE ◽  
Banu MÜJDECİ ◽  
Erkan KARATAŞ
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Impulse Test ◽  
Control Group ◽  
Study Group ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Before And After ◽  
Paroxysmal Positional Vertigo

Purpose: Vestibuloocular reflex (VOR) may be helpful in the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV). Video Head Impulse Test (vHIT) can effectively diagnose VOR deficits in vestibular disorders. Aims: The aim of this study is to investigate the significance of vHIT in determining the efficacy of therapeutic maneuvers in individuals with posterior semicircular canal BPPV. Materials and Methods: The study included 25 patients with posterior SCC BPPV (Study Group) between the ages of 19-65 years, 30 healthy individuals (Control Group). All individuals underwent otorhinolaryngologic examination, audiological evaluation with, videonystagmography and vHIT. The Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) were administered to the individuals with posterior SCC BPPV for the intensity of dizziness and Modified Epley maneuver was performed 3 times at an interval of 3 days. The vHIT, DHI and VAS were re-administered to these individuals 1 week after improvement was detected in positional nystagmus. Results: There was no significant difference between the study and control groups in terms of vHIT gains for all bilateral SCCs before therapeutic maneuver (p>0.05). In the study group, there was no significant difference between vHIT gains of all bilateral SSCs before and after therapeutic maneuvers (p>0.05). No asymmetry or refixation saccades (overt and covert) were observed in any of the individuals in both groups during all measurements. Compared to before therapeutic maneuvers, there was a significant decrease in dizziness-related disability level assessed by DHI and intensity of dizziness assessed by VAS in the study group after the improvement (p<0.001). Conclusion: It was found that vHIT was not a diagnostic test in BPPV and in terms of evaluating the efficacy of therapeutic maneuvers. Subjective evaluations determining the intensity of dizziness and level of dizziness-related disability in BPPV provided supportive information in diagnosis and in determining the efficacy of therapeutic maneuvers.

scholarly journals Effect of barbecue role and Gufoni maneuvers on quality of life in patients with horizontal semicircular canal benign paroxysmal positional vertigo

2020 ◽  
Vol 6 (7) ◽  
pp. 1311
Author(s):  
Kumar Gourav Sharma ◽  
Ashok Kumar Gupta
Keyword(s):  
Quality Of Life ◽  
Benign Paroxysmal Positional Vertigo ◽  
Post Treatment ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Before And After ◽  
Positive Effect ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is the most common cause in patients with vertigo. Horizontal semi-circular canal BPPV (HSCBPPV) is up to 20% of BPPV. Quality of life (QoL) is significantly impaired by vertigo. Aim of present research was to study the effect and compare barbecue role and Gufoni maneuvers on QoL in patients with HSCBPPV.</p><p class="abstract"><strong>Methods:</strong> 60 individuals with unilateral HSCBPPV were selected. 2 groups barbecue role and Gufoni were formed and 30 individuals were selected in each group randomly. Vestibular activities and participation (VAP) and positional test were administered before and after barbecue role and Gufoni maneuvers to fulfill the aim.  </p><p class="abstract"><strong>Results:</strong> VAP scale results revealed significant difference between pre and post treatment score in both groups, suggestive of positive effect on quality of life in patients with HSCBPPV. Improvements in VAP score between both groups were compared and significant difference was observed. Positional test post treatment revealed that 83.33% and 70% patients improved in barbecue role and Gufoni respectively.</p><p class="abstract"><strong>Conclusions:</strong> Barbecue role found to be better than Gufoni in treatment of unilateral HSCBPPV.</p>

scholarly journals Benign Paroxysmal Positional Vertigo Treated with Maneuvers to Change Head Position.

1995 ◽  
Vol 88 (7) ◽  
pp. 857-862
Author(s):  
Takayoshi ITAYA ◽  
Hiroya KITANO ◽  
Yoshiro YAZAWA ◽  
Akira KODAMA ◽  
Ichiro KOMADA ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The Effects of Receiver Placement on Probe Microphone, Performance, and Subjective Measures with Open Canal Hearing Instruments

2010 ◽  
Vol 21 (04) ◽  
pp. 249-266 ◽  
Author(s):  
Lynzee N. Alworth ◽  
Patrick N. Plyler ◽  
Monika Bertges Reber ◽  
Patti M. Johnstone
Keyword(s):  
Repeated Measures ◽  
Hearing Aid ◽  
Clinical Importance ◽  
Ease Of Use ◽  
Subjective Measures ◽  
Repeated Measures Design ◽  
Hearing Instruments ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Occlusion Effect

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.

scholarly journals Effects of cranial osteopathic techniques in the symptoms of benign positional paroxistic vertical

2020 ◽  
Vol 18 ◽  
pp. 1-5
Author(s):  
Otávio Augusto do Nascimento Oliveira ◽  
Laiana Sepúlveda de Andrade Mesquita ◽  
Maurício Rocha Mendes ◽  
Lílian Maria Magalhães Costa de Oliveira ◽  
Laís Cristina Almeida
Keyword(s):  
Statistical Analysis ◽  
Benign Paroxysmal Positional Vertigo ◽  
Intervention Group ◽  
Control Group ◽  
Common Cause ◽  
A Value ◽  
Positional Vertigo ◽  
Before And After ◽  
Temporal Bones ◽  
Paroxysmal Positional Vertigo

Background: The benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness among the population. The osteopathy is a practice of manual therapy which is guided by a holistic perspective of human being, the cranial osteopathy affirms that the respective bones of the cranium represent mobility. Objective: To investigate the effect of the cranial osteopathy techniques on the benign paroxysmal positional vertigo. Methods: The current study included 20 female subjects, each one of them with benign paroxysmal positional vertigo, distributed in two groups, an intervention group and a control group (placebo); in order to detect the BPPV, was applied the Dix-Hallpike test before and after the interventions. Three techniques of cranial osteopathy were used on the structures related to vestibule and to the temporal bones: mobilization of temporal bones, tensioning of cerebellar tentorium and mobilization of eyeball. All statistical analyzes were performed using the GraphPad Prism 6.0 software (GraphPad Software, CA).Results: Among the intervention group, 7 of 10 individuals were negative to the Dix-Hallpike test, whilst individuals of the control group remained positive to the test. In the statistical analysis verified that the intervention with osteopathic techniques had a significant effect in compared to the control group, with a value p=0.0261. Conclusion: The cranial osteopathy appears to be able of produce effects on the vestibular activity, whereas were able to reduce, in a significant means, the symptoms concerning to BPPV.

scholarly journals The Dix-Hallpike and Modified Epley Manoeuvres in the diagnosis and management of Benign Paroxysmal Positional Vertigo (BPPV)

2004 ◽  
Vol 3 (1) ◽  
pp. 36-37
Author(s):  
Matthew Clarke ◽  
◽  
Liz Stallworthy ◽  
J Dulay ◽  
◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Balance Disorders ◽  
Diagnosis And Management ◽  
Positional Vertigo ◽  
Rapid Changes ◽  
Common Balance ◽  
Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common balance disorders and one of the easiest to diagnose and treat. It is characterised by short lived episodes of vertigo and geotropic rotatory nystagmus, which occur a few seconds after rapid changes in head position. The vertigo usually lasts no more than a minute and the symptoms reduce in severity with repetitions of the evoking movement.

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

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