The clinical characteristics of the benign paroxysmal positional vertigo associated with Meniere's disease

Abstract

To explore the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease (MD) in retrospect in an effort to improve the diagnosis and efficacy of treatment. Fifteen cases (1 male and 14 female, aged 46 to 68 years old) of BPPV associated with MD from July 2007 to June 2009 were retrospectively analyzed. Patient clinically characterized with positional paroxysmal vertigo were diagnosed as MD by ECochG and glycerol test and were confirmed as BPPV associated with MD by Dix Hallpike test or roll test. They were treated with Epley maneuver or Barbecue rol maneuver according to the type of BPPV, and the efficacy was evaluated. (1) Most cases involved female patients in this study; (2) BPPV occurred after MD in al of the cases, of which 13 cases were posterior semicircular canal lithiasis (9 cases in the same ear, 2 in the other and 2 in both) and 2 cases were horizontal semicircular canal lithiasis (cupula lithiasis in the same ear); (3) in this study, 10 patients were cured after 3-4 times of posture treatment (66.7%), 4 patients were cured after 5 times and 1 patient received endolymphatic sac decompression because of recurrent vertigo. (1) BPPV can result from MD, for which a possible mechanism may be the hydrolabyrinth that lead to eardust falling off. (2) Most cases of BPPV occurred in the posterior semicircular canal in the same ear. Most cases in incidence rate have obvious sexual bias in female. (3) Eardust reposition is an effective treatment for BPPV caused by MD; while it is refractory compared to ordinary BPPV and require multiple treatments, which may be related to the recurrence of hydrolabyrinth.