Hyun-Ah Kim1, Hyung Lee2. 1. Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea. 2. Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea. Electronic address: hlee@dsmc.or.kr.
Abstract
OBJECTIVE: To investigate whether residual dizziness after successful treatment in patients with benign paroxysmal positional vertigo (BPPV) was associated with autonomic dysfunction. METHODS: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures (CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and divided into two groups with and without residual dizziness. We performed a standardized autonomic function test. RESULTS: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the next follow-up than those without residual dizziness (40% and 3%, p=0.000). Compared to patients without residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different between the patients with and without residual dizziness. CONCLUSION: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural autonomic dysfunction. SIGNIFICANCE: This investigation could be useful in understanding the mechanism of residual dizziness in patients with BPPV.
OBJECTIVE: To investigate whether residual dizziness after successful treatment in patients with benign paroxysmal positional vertigo (BPPV) was associated with autonomic dysfunction. METHODS: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures (CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and divided into two groups with and without residual dizziness. We performed a standardized autonomic function test. RESULTS: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the next follow-up than those without residual dizziness (40% and 3%, p=0.000). Compared to patients without residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different between the patients with and without residual dizziness. CONCLUSION: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural autonomic dysfunction. SIGNIFICANCE: This investigation could be useful in understanding the mechanism of residual dizziness in patients with BPPV.
Authors: Hyun Ah Kim; Alexandre Bisdorff; Adolfo M Bronstein; Thomas Lempert; Marcos Rossi-Izquierdo; Jeffrey P Staab; Michael Strupp; Ji-Soo Kim Journal: J Vestib Res Date: 2019 Impact factor: 2.354