Incidence of Benign Paroxysmal Positional Vertigo and Course of Treatment Following Mild Head Trauma-Is It Worth Looking For?

Abstract

This study aimed to identify the incidence of benign paroxysmal positional vertigo following head trauma. This study is a prospective cross-sectional study. Initially, a targeted search for the identification of patients with the international classification of diseases (ICD-10) diagnosis of cerebral commotio at relevant emergency units in the Northern Region of Denmark was done. This was followed by a clinical examination to determine the incidence of benign paroxysmal positional vertigo (BPPV) within this population. Of the 295 patients diagnosed with commotio cerebri during a 4-and-a-half month period, 85 patients were included. All patients underwent clinical examination in a mechanical repositional chair wearing Video Frenzel Goggles. Additional examinations included a complete video head impulse test. A total of six patients were identified with benign paroxysmal positional vertigo (BPPV) following minor head trauma. Bilateral BPPV, multicanal BPPV, and BPPV of a single semicircular canal were identified. All patients experienced relief of benign paroxysmal positional vertigorelated symptoms within 3 treatment sessions. Five patients were identified with a pathological video head impulse test, 54 with an inconclusive examination, and 15 with a normal video head impulse test. The incidence of benign paroxysmal positional vertigo following minor head trauma was 7%. A relatively high number of atypical subtypes of benign paroxysmal positional vertigo was found. When applying strict criteria for the interpretation of video head impulse test examination, the number of patients with inconclusive video head impulse test examination was higher than expected and 6.7% of patients had a pathological video head impulse test examination. No relationship between benign paroxysmal positional vertigo and pathological video head impulse test was observed.