Clinical analysis of benign paroxysmal positional vertigo secondary to Menieres disease

Abstract

In the present study, the clinical characteristics of 15 cases of benign paroxysmal positional vertigo (BPPV) secondary to Meniere’s disease (MD) were retrospectively analyzed, in order to improve the diagnosis and therapeutic efficacy. Patients clinically characterized as positional paroxysmal vertigo were diagnosed as MD by electrocochleography (ECochG) and glycerol test and were confirmed as BPPV associated with MD by Dix-Hallpike test and roll test. They were treated with Epley maneuver or Barbecue roll maneuver according to the type of BPPV, and the efficacy was evaluated. BPPV occurred after MD in all of the cases, of which 13 cases were posterior semicircular canal lithiasis and 2 cases were horizontal semicircular canal lithiasis. In this study, 10 patients were cured after 3 to 4 times of posture treatment (66.7%), 4 patients were cured after no less than 5 times and 1 patient received endolymphatic sac decompression because of recurrent vertigo. BPPV can result from MD, and a possible mechanism may be the hydrolabyrinth that lead to otolith falling off. BPPV occurred in the ipsilateral posterior semicircular canal in majority of cases, with an obvious sexual bias to female. Otolith reposition is an effective method to treat BPPV secondary to MD, while it is refractory compared to simple BPPV and requires multiple times of treatments. This may be related to the recurrence of hydrolabyrinth. Key words: Meniere’s disease, benign paroxysmal positional vertigo.