Subjective visual vertical after treatment of benign paroxysmal positional vertigo

Maristela Mian Ferreira,Maurício Malavasi Ganança,Heloisa Helena Caovilla

doi:10.1016/j.bjorl.2016.08.014

Maristela Mian Ferreira, Maurício Malavasi Ganança + Show 1 more

Open Access

https://doi.org/10.1016/j.bjorl.2016.08.014

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Abstract

IntroductionOtolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. ObjectiveTo compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo. MethodsWe evaluated 20 patients. The estimated position where a fluorescent line within a bucket reached the vertical position was measured before and immediately after the particle repositioning maneuver. Data were tabulated and statistically analyzed. ResultsBefore repositioning maneuver, 9 patients (45.0%) had absolute values of the subjective visual vertical above the reference standard and 2 (10.0%) after the maneuver; the mean of the absolute values of the vertical deviation was significantly lower after the intervention (p<0.001). ConclusionThere is a reduction of the deviations of the subjective visual vertical, evaluated by the bucket test, immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo.

Highlights

Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction
The benign paroxysmal positional vertigo (BPPV), recognized as a common cause of vertigo with a higher prevalence in females and in the elderly, in most cases is unilateral and idiopathic. It is characterized by episodes of sudden vertigo and/or positional nystagmus, of short duration, and may be accompanied by nausea; it occurs when there is a change of position of the head due to otolith fractionation of utricular macula, and the displacement of these particles to the semicircular canals.3---8
The criterion for inclusion of patients was the diagnosis of BPPV, made by the otolaryngologist, based on clinical history and the presence of vertigo and positional nystagmus when undergoing Dix-Hallpike test[9] and head rotation,[10] to identify the impaired labyrinth and the semicircular canal

Summary

Introduction

Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. Objective: To compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo. The benign paroxysmal positional vertigo (BPPV), recognized as a common cause of vertigo with a higher prevalence in females and in the elderly, in most cases is unilateral and idiopathic It is characterized by episodes of sudden vertigo and/or positional nystagmus, of short duration, and may be accompanied by nausea; it occurs when there is a change of position of the head due to otolith fractionation of utricular macula, and the displacement of these particles to the semicircular canals.3---8. The characteristics of the positional nystagmus elicited by the Dix-Hallpike test[9] or the test of head rotation[10] identify the affected labyrinth and semicircular canal.[10]

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