Persistent Benign Paroxysmal Positional Vertigo Research Articles

Analysis of patient variables including socioeconomic indicators and their association with recurrence rates and persistence of benign paroxysmal positional vertigo: A retrospective case series.

Analysis of patient variables including socioeconomic indicators and their association with recurrence rates and persistence of benign paroxysmal positional vertigo: A retrospective case series.

Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver.

To evaluate whether immediate post-canalith repositioning maneuver (CRM) vestibular changes are predictive of benign paroxysmal positional vertigo (BPPV) resolution. Retrospective cohort study. Tertiary referral center. Adults (n = 27) with posterior canal BPPV. Single CRM with Frenzel goggles. The Visual Analog Scale (VAS) for disequilibrium, the subjective visual vertical (SVV), the subjective visual horizontal (SVH), and the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) were administered pre- and immediately following single CRM. Dix-Hallpike was performed 1-3 weeks after CRM to assess for BPPV resolution. Pre- and post-treatment vestibular assessments were compared between groups to determine if post-CRM vestibular changes could predict BPPV resolution. The change in VAS score following CRM treatment was statistically different between patients who responded to CRM treatment (n = 15) and those who did not (n = 12), (-0.07 points versus -2.40 points, respectively; P = 0.03). Likewise, a significantly greater improvement in SVV score was observed for CRM responders compared with CRM nonresponders (0.92° versus -0.06°, respectively; P = 0.02). Change in SVH and mCTSIB scores did not differ significantly between groups. Additionally, patient age was found to predict outcome of CRM treatment, with older patients more likely to experience persistent BPPV (P ≤ 0.01). Immediate improvement in VAS and SVV scores following CRM may be useful in predicting resolution of BPPV and may assist in directing the timing and need for future interventions. Younger age may have a favorable predictive value for improvement following single CRM.

Effectiveness of using Epley’s manoeuvre in benign paroxysmal positional vertigo

Introduction: Generally BPPV is a self-limiting disorder that can resolve spontaneously due to the ability of the endolymph to dissolve otoconia. Traditionally, fatiguing vestibular rehabilitation exercises were given to patients with persistent BPPV. The introduction of the Canalith Repositioning procedure (CRP) or Particle Repositioning Manoeuvre (PRM) by Semont and Epley has revolutionized the management of BPPV to the point that most physicians, paramedical health care providers and even self-treated patients have used these manoeuvre. Our study is conducted to prove the efficacy of particle repositioning manoeuvres in the treatment of BPPV.Aim: To evaluate the outcome of Epley Maneuver in treating Benign Paroxysmal Positional Vertigo (BPPV).Materials and Methods: This study was conducted in the ENT department of Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari district in a time period from December 2019 to February 2020. The sample size was taken as 35 patients who had presented with complaints of giddiness, dix hallpike’s and Epley’s maneuver were done for those patients who fulfilled the inclusion criteria. The study was conducted after obtaining the clearance from Institutional Human Ethical Committee.Study Design: Prospective descriptive study.Results and analysis: When interviewed at the time of conducting the study, the vast majority of the patients claimed a dramatic improvement reflected in complete cessation of vertigo in 31 patients (88 %). In the remaining 4 patients, 2 patients showed improvement at the end of 1 week and two patient claimed no relief at all. Even though literature claims up to 30% of recurrence within one year in our study no patient had recurrence within this six months follow up.Conclusion: Epley Maneuver is safe, reliable and effective procedure that can be performed in general practice at the bedside without having any significant side effects in treating patients with Benign Paroxysmal Positional Vertigo.Posterior semicircular canal involvement is most common. Right side is predominant to left. Particle repositioning manoeuvre is effective way to treat and give immediate relief to the patients even though it is a self-limiting disease.

Практические аспекты диагностики и лечения доброкачественного пароксизмального позиционного головокружения при каналолитиазе заднего полукружного канала

Objective: The aim of the study is to assess the effectiveness of diagnosis of benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal (PSC) when using different types of Frenzel glasses compared to visual observation of nystagmus, as well as the features of diagnostic tests and therapeutic maneuvers during the initial treatment of patients with DPPV of PPC and their subsequent treatment, if necessary, multiple repetition of therapeutic maneuvers. Materials and methods: The study included 240 patients with newly diagnosed idiopathic BPPG canalolithiasis of PSC, which were divided into groups to determine 1) the appropriateness of using different types of Fresnel goggles in the diagnosis of BPPPV, 2) to determine the optimal sequence of testing of the supposed affected and unaffected parties in the test Dix-Hallpike, 3) to determine the optimal number of Epley healing maneuvers during one consultation. Results: Diagnosis of BPPPV of PPC during initial patient treatment significantly increases when using modified Fresnel goggles or video Frenzel in the Dix-Hallpike test. At the initial consultation, when conducting diagnostic tests and medical maneuvers to detect BPPV of PSC in a patient with positional vertigo, it is advisable to begin their execution from the supposed affected side according to the anamnesis in order to optimize the doctor’s time expenditures. In the absence of resolution of otolithiasis in case of BPPV of PSC after a single maneuver, multiple therapeutic maneuvers significantly prolong the visit approximately until 28 minutes. The treatment of patients with resistant persistent BPPV should be organized during the special prolonged otoneurologist consultation in order repeating maneuvers could be carried out. During one consultation not more than three repositioning maneuvers should be done, as the increase of number of maneuvers does not affect the effectiveness of BPPV treatment.

Response to “Possible Errors in the Article ‘Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo’” from Entong Wang

Response to “Possible Errors in the Article ‘Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo’” from Entong Wang

Possible Errors in the Article “Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo”

Possible Errors in the Article “Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo”

Persistent benign paroxysmal positional vertigo: our experience and proposal for an alternative treatment

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Despite the great efficacy of canalith repositioning procedures (CRPs), BPPV may persist (PBPPV). The aim of the study was to evaluate whether a prolonged and self-assessed temporal bone vibration (TBV) could change the outcome of PBPPV after 12 months of repeated treatments, in order to avoid further invasive and/or drug therapies. This evaluation was also conducted with respect to the entire BPPV population treated with CRPs. Seventy-two patients affected by PBPPV were enrolled in the study: 51 and 21 of them suffering from posterior semicircular canal (PSC) and lateral semicircular canal (LSC), respectively. PBPPV patients underwent a twice-a-day self-assessed TBV, using a common low-intensity massaging cushion. Patients were re-tested 1 week later and they were considered free from disease as the results of the positioning tests continued to be negative after 1 month. 70.6 % of PSC PBPPV and 61.9 % of LSC PBPPV patients had positive and statistically significant (P < 0.01) outcomes not biased by "age" and "gender" variables. The recurrence rate of BPPV (RBPPV) was also studied in the BPPV and PBPPV groups after a 12/24-month follow-up and any statistically significant result was found in multiple regression analysis between nuisance variables and RBPPV patients previously treated by CRPs or TBV. The present study suggests that the self-assessed and prolonged TBV could be an alternative treatment in patients affected by PBPPV otherwise addressed to undergo more invasive procedures and pharmacological treatment that are not completely side effects free.

Chiropractic Management of Benign Paroxysmal Positional Vertigo Using the Epley Maneuver: A Case Series

ObjectiveThe purpose of this case series is to describe the management of benign paroxysmal positional vertigo in a chiropractic clinical setting. Clinical FeaturesEight patients (4 women, 4 men) with symptoms of persistent benign paroxysmal positional vertigo presented for chiropractic care. The outcome measures included self-reported resolution of vertigo, a Short Form 12 Health Survey, Measure Yourself Medical Outcome Profile, and the Dix-Hallpike maneuver. Outcome measures were assessed at initial assessment, 6 days, 30 days, and 3 months postintervention. Intervention and OutcomeThe patients underwent one or more canalith repositioning procedures (Epley maneuver). Scores in each of the categories decreased from the initial to 6-day assessment and then again at the 30-day assessment. The effects of the treatment on the Short Form 12 scores showed changes between the initial assessment and 30 days posttreatment. ConclusionThe patients in this case series demonstrated reduction in symptoms with chiropractic management.

Clinical Features of Recurrent or Persistent Benign Paroxysmal Positional Vertigo

To identify clinical features and causes of recurrent or persistent benign paroxysmal positional vertigo (BPPV) and to analyze the effectiveness of frequently repeated canalith repositioning procedures (CRPs). Case series with chart review. Academic university hospital. The authors retrospectively reviewed the clinical records of 120 patients who were diagnosed with BPPV at the Dizziness Clinic in Ajou University Hospital, Korea, between 2004 and 2008. "Persistent" and "recurrent" BPPV were respectively defined as BPPV continuing more than 2 weeks and recurring BPPV in the same canals after at least 2 weeks of a symptom-free interval following previous successful treatments. The authors treated patients with frequently repeated CRPs such as the modified Epley maneuver or a barbecue rotation every 2 or 3 days in the outpatient clinic. Among 120 patients with BPPV, 93 (77.5%) were typical, 15 (12.5%) were persistent, and 12 (10.0%) were recurrent. Although the most common cause was idiopathic in both recurrent and persistent BPPV, secondary causes, including trauma, were much more common in recurrent and persistent BPPV than in typical BPPV. Typical and recurrent BPPV developed most commonly in the posterior semicircular canals. Persistent BPPV was most commonly detected in the lateral semicircular canals. After frequently repeated CRPs, 91.7% and 86.7% of the patients with recurrent or persistent BPPV, respectively, had resolution of nystagmus and vertigo. Recurrent and persistent BPPV are not rare diseases and occur with a higher incidence than expected, especially in patients with secondary causes. However, they can be successfully treated with frequently repeated CRPs.

Benign paroxysmal positional vertigo recurrence and persistence

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%.

Benign paroxysmal positional vertigo recurrence and persistence

SummaryBenign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders.AimTo study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year.Study designlongitudinal contemporary cohort series.Materials and MethodsOne 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.ResultsAfter 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%.

Positional nystagmus in patients with chronic dizziness

Background: In elderly people, chronic dizziness is endemic. However, chronic dizziness of unknown origin is difficult to assess. Objective: To investigate whether mild unrecognised benign paroxysmal positional vertigo (BPPV) is...

良性発作性頭位げんうん症（ＢＰＰＶ）に対するＥｐｌｅｙ法の効果

Benign paroxysmal positional vertigo (BPPV) is the most common 'provoked vertigo'. In Japan, there has not been any physiotherapy attempted for this clinical entity and this is the first report implementing the method described by Epley. Two techniques were used in this small preliminary series. One was the conventional Epley's maneuver using a vibrator and the other involved the same head positions without a vibrator but tapping the mastoid bone with fingers or fist. Fifteen BPPV patients with classic nystagmus were selected and underwent therapy by one of the two methods. In thirteen of the fifteen patients, no further positioning vertigo occurred after a single session. But two patients said that they felt light dizziness due to other unknown causes, which were not associated with changing the head position. One was completely cured after three sessions. In one patient, BPPV partially remained. As the patient had concomitant heart disease, she could not undergo another session. None of the patients were unchanged or worse after the treatment. Epley's maneuver either with or without a vibrator showed excellent results. We recommend that this be the first choice of treatment for persistent BPPV.

Surgical section of the posterior ampullary nerve.

Surgical section of the posterior ampullary nerve (PAN) has been used as a form of therapy for persistent benign paroxysmal positional vertigo (BPPV). Eighteen patients were reviewed. The PAN was identified in 16 patients, 15 of whom were completely cured and one of whom had improvement of symptoms. Severe sensorineural hearing loss (SNHL) occurred in three patients. This study suggests that surgical section of the PAN is effective. The procedure is facilitated by a postauricular incision and canalplasty.