Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

Background: Traumatic brain injury is a common secondary cause of Benign Paroxysmal Positional Vertigo(BPPV). Objective: To determine the incidence and clinical profile of patients with BPPV in mild and moderate head injury. Materials and Methods: A prospective observational study done in patients admitted with mild and moderate head injury who developed BPPV from January 2020 to March 2020 in a tertiary care hospital of South India. Demographic and clinical parameters were noted and were treated with canalith repositioning procedures. Results: Among 42 patients admitted with mild and moderate head injury, 9(21.4%) were diagnosed with BPPV in the follow up. The male female ratio was 2.5:1. The mean age was 44 ±21.4years.Two wheeler accidents contributed to nearly half of (55.6%) traumatic BPPV. Posterior canal was commonly involved in 7(77.8%) followed by horizontal in 2 (22.2%).The type of head injury was mild in 7 (77.8%) and moderate in 2 (22.2%) in traumatic BPPV patients. 5 (55.6%) patients with BPPV had abnormal findings in neuroimaging. 4 (44.4%) patients developed recurrent BPPV in our cohort. Conclusion: The incidence of traumatic BPPV was 21.4% in our study. Road traffic accidents due to two wheeler accidents were the common mode of head trauma. Posterior canal was commonly involved in three fourth of cases. Recurrence of vertigo was documented in 4 (44.4%).

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An Analysis of Aetiology, Pattern and Outcome of Head Injury in Trauma Patients

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0903.05 ◽

2022 ◽

Vol 9 (3) ◽

pp. 16-21

Author(s):

Sudatta Waghmare ◽

ashish Aswar ◽

Hiranya Deka ◽

Aman Singh ◽

Arjav Nanavati ◽

...

Keyword(s):

Blood Pressure ◽

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Tertiary Care ◽

Care Hospital ◽

Road Traffic Accidents ◽

Major Health Problem ◽

Female Ratio ◽

Associated Injury

Abstract Background: Head injury is considered as a major health problem in developed and developing nations. Analysis of etiology, patterns, and outcome of head injury in trauma patient is essential for understanding and planning for better management. Materials and Methods: The prospective observational study carried out among patients who presented with head injury at the tertiary care hospital, Mumbai from July 2015 to July 2017. Demographic details recorded were age, sex, blood pressure on arrival, Glasgow Coma Scale (GCS) score, the interval between injury and admission, associated injury, co-morbidities, hospital stay, and outcome. Results: The age group at which maximum patients of head injury were admitted was 18-29 years (31%) followed by 40-49 years (21%). Eighty one percent patients were males and 19% patients were females, the male to female ratio being 4:1. Road traffic accidents (36% cases) were the commonest cause leading to acute head injury followed by accidental fall (21% cases). 47% patients presented with mild head injury according to GCS. Conclusion: Head injuries mainly caused by vehicular accidents and affect mainly the young men. Road traffic accidents were the commonest mode of head injury, but railway accident had the worst outcome in our study. Factors associated with outcome were Pre-hospital delay, GCS on arrival, Blood pressure on arrival, Associated injury, Need for ventilator support, CT scan findings.

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Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1718780 ◽

2021 ◽

Author(s):

Sukriti Das ◽

Bipin Chaurasia ◽

Dipankar Ghosh ◽

Asit Chandra Sarker

Keyword(s):

Head Injury ◽

Road Traffic ◽

Head Injuries ◽

Skull Fracture ◽

Tertiary Care ◽

Acute Subdural Hematoma ◽

Care Hospital ◽

Female Ratio ◽

Mortality And Morbidity ◽

The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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Effectiveness of Semont maneuver in the treatment of benign paroxysmal positional vertigo: an institutional study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205440 ◽

2020 ◽

Vol 7 (1) ◽

pp. 27

Author(s):

Swapna U. P. ◽

Smitha B. ◽

Salil Kumar K.

Keyword(s):

Semicircular Canal ◽

Benign Paroxysmal Positional Vertigo ◽

Tertiary Care ◽

Head Movements ◽

Treatment Modalities ◽

Controlled Study ◽

Care Hospital ◽

Posterior Semicircular Canal ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. In this condition, the vertigo is precipitated by certain head movements. BPPV is diagnosed by Dix-Hallpike positional test. Various repositioning maneuvers and treatment modalities exist for the management of this condition. Semont maneuver is a simple procedure for the treatment of posterior semicircular canal BPPV.Methods: This non randomized controlled study was conducted in the ENT Department of a tertiary care hospital at Thiruvananthapuram over a period of one year. Hundred patients with posterior semicircular canal BPPV were included in the study. Fifty patients treated with Semont maneuver were compared with 50 patients who were treated with betahistine 16 mg three times daily. Outcomes were measured by relief of vertigo and negative Dix- Hallpike positional test during follow up examination.Results: The most common age group affected by BPPV was 50-60 years. Right side was more affected than the left. There was a female preponderance. 84% patients treated with Semont maneuver were cured at the end of the first week and 90% at the end of the second week. The percentage of patients cured with betahistine were 48% at the end of first week and 56% at the end of second week. Conclusions: The Semont maneuver was very effective in the treatment of BPPV. It helps to reduce the long-term use of medicines in our population.

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Benign Paroxysmal Positional Vertigo: Comparison of Idiopathic BPPV and BPPV Secondary to Vestibular Neuritis

Ear Nose & Throat Journal ◽

10.1177/0145561319871234 ◽

2019 ◽

pp. 014556131987123 ◽

Cited By ~ 3

Author(s):

Bilge Türk ◽

Meltem Akpinar ◽

Kerem Sami Kaya ◽

Arzu Yasemin Korkut ◽

Suat Turgut

Keyword(s):

Clinical Features ◽

Clinical Data ◽

Benign Paroxysmal Positional Vertigo ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Vestibular Neuritis ◽

Care Hospital ◽

Posterior Semicircular Canal ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

The aim of this study was to reveal clinical features of benign paroxysmal positional vertigo (BPPV) through comparing idiopathic BPPV and BPPV secondary to vestibular neuritis (VN). The clinical data of the 189 BPPV patients admitted to our tertiary care hospital including otolaryngological, audiological, vestibular, neurological, and radiological evaluations were reviewed. Patients diagnosed with idiopathic BPPV (n = 145) and BPPV secondary to VN (n = 44) were grouped as I and II, respectively. The clinical data of 2 groups were compared. The findings of the study showed that the patients with secondary BPPV due to VN are much younger, have symptoms of only posterior semicircular canal involvement, and require more treatments compared to patients with idiopathic BPPV. The clinical features of patients with BPPV secondary to VN and idiopathic BPPV differ on several aspects. More extensive studies are needed to investigate the underlying etiology in patients with BPPV encountered after VN.

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Prevalence of Benign Paroxysmal Positional Vertigo: Our experiences at a tertiary care hospital of India

Egyptian Journal of Ear Nose Throat and Allied Sciences ◽

10.21608/ejentas.2018.5246.1040 ◽

2018 ◽

Vol 19 (3) ◽

pp. 87-92 ◽

Cited By ~ 1

Author(s):

Santosh Swain ◽

Ishwar Behera ◽

Mahesh Sahu

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

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Clinico-Aetiological Profile of Patients with Vertigo: A Cross-sectional Observational Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45457.14003 ◽

2020 ◽

Author(s):

Shiraz Syed ◽

Himanshu Kumar Mittal ◽

Sampan Singh Bist ◽

Lovneesh Kumar ◽

Vinish Kumar Agarwal

Keyword(s):

Observational Study ◽

Orthostatic Hypotension ◽

Benign Paroxysmal Positional Vertigo ◽

Tertiary Care ◽

Aetiological Factor ◽

Cross Sectional ◽

Duration Of Symptoms ◽

Female Ratio ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

Introduction: Nearly 5-10 percent of patients seen in general OPD, and between 10-20 percent of patients seen by ENT specialists and neurologists are those with complaints pertaining to vertigo and dis-equilibrium. The standard definition of vertigo states it to be an illusion of motion particularly rotatory sensation. Overlapping symptoms and terms such as dizziness, light headedness, giddiness and pre-syncope make it challenging to achieve a proper diagnosis. Aim: To study the clinical profile and revisit the various aetiological factors for vertigo in patients with actual sensation of rotatory motion seen in contemporary Otolaryngology practice. Materials and Methods: The present study was a cross-sectional observational study carried out over a period of 12 months in the Department of Otorhinolaryngology at a tertiary care centre. One-hundred and ten cases complaining of the sense of rotation of either head or their surroundings with at least a single episode in preceding one month were included. Comprehensive otological and vestibular evaluation was done. Each patient was subjected to thorough clinical vestibular and laboratory tests. Subjects with known cervical spine disease, neurological disorders and cardiac ailments were excluded. Statistical analysis was done and Chi-square test was applied. Results: The mean age of patients in the study was 49.75 years with a male to female ratio of 1:1. Majority of the patients (90%) presented with acute onset of vertigo. The total duration of symptoms most commonly observed ranged between one week to one month. Nearly, all patients had intermittent character of vertigo. The duration of each episode in most of the patients ranged between 1 minute to 10 minutes. Maximum patients (90.9%) were observed with intensity of vertigo as mild and moderate type (Level II and III SVVSLCRE). Positional variation was observed in 64.5% of the patients. The most common aetiological diagnosis deduced from the study was benign paroxysmal positional vertigo (30.4%) followed by orthostatic hypotension (17.9%) and Meniere’s disease (13.4%). Conclusion: The most common aetiological factor of vertigo was found to be benign paroxysmal positional vertigo, which can be effectively treated by performing Epley’s maneuver. Orthostatic hypotension has been observed as an important cause liable to be missed by otologists. The management of vertigo must be directed by a meticulous work up of aetiologies and should not be treated under a blanket regimen.

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