Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR) protocol was applied in cases of persistent BPPV. RESULTS: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.
Highlights
Benign paroxysmal positional vertigo (BPPV) is characterized by rotatory dizziness triggered by head movements such as the ones caused by neck hyperextension and when the patient stands up or lies down on bed[1]
We considered non-recurrent BPPV those patients who did not have BPPV recurrences during this period, after statocone repositioning maneuvers (SRM). We considered it recurrent BPPV the clinical manifestation of vertigo signs and symptoms after vertigo and nystagmus subsiding with SRM, seen by the otorhinolaryngologist along one year after SRM
In 4% of the patients, positional vertigo and nystagmus were not suppressed with SRM during one year, the BPPV was deemed persistent
Summary
Benign paroxysmal positional vertigo (BPPV) is characterized by rotatory dizziness triggered by head movements such as the ones caused by neck hyperextension and when the patient stands up or lies down on bed[1].Vertigo and other associated symptoms are triggered by fragments of statocones coming from the utriculus macula, which move to one or more semicircular canals and turn the cupule into a gravity-sensitive organ[2].A number of treatments have been proposed for BPPV, including drugs, surgery and vestibular rehabilitation exercises. Benign paroxysmal positional vertigo (BPPV) is characterized by rotatory dizziness triggered by head movements such as the ones caused by neck hyperextension and when the patient stands up or lies down on bed[1]. Vertigo and other associated symptoms are triggered by fragments of statocones coming from the utriculus macula, which move to one or more semicircular canals and turn the cupule into a gravity-sensitive organ[2]. Cupula lithiasis and duct lithiasis theories allowed for the creation of maneuvers aiming at cleaning the cupule and the semicircular canal ducts of statocone fragments. In 1988, in Paris, Alain Semont et al.[3] and in 1992, in the USA, Epley[4] described the first statocone repositioning maneuvers (SRM). The success rate after one session was of 83.96% for the Semont maneuver and 97.70% for the Epley’s
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