Cristina Vaduva1, Jonathan Estéban-Sánchez1, Ricardo Sanz-Fernández1, Eduardo Martín-Sanz2. 1. Department of Otolaryngology, University Hospital of Getafe, Autovía de Toledo, km 12,500, 28905, Getafe, Madrid, Spain. 2. Department of Otolaryngology, University Hospital of Getafe, Autovía de Toledo, km 12,500, 28905, Getafe, Madrid, Spain. emartinsanz@gmail.com.
Abstract
OBJECTIVES: To evaluate the prevalence and management of residual symptoms in recovered BPPV patients. METHODS: We performed a retrospective study on BPPV patients of any of the three semicircular canals. Exclusion criteria were multiple-canal BPPV, refractory BPPV, central nervous system pathologies or other vestibular diseases. Patients were treated with repositioning maneuvers until the vertigo disappeared and evaluated for symptoms of instability at 1 month after resolution. A dynamic computerized posturography was then performed on every patient complaining of residual instability. We analyzed demographic data, the affected semicircular canal, number of repositioning maneuvers, presence of anxiety disorders, and we correlated these variables with the presence of residual disequilibrium 1 month after vertigo resolution. RESULTS: We included 361 patients. Residual disequilibrium was found in 107 patients (29.6%) with no significant difference between the rates associated with the three semicircular canals (p = 0.73). The group who needed more than one repositioning maneuver (1 maneuver-229 patients, ≥ 2maneuvers-132 patients) showed a significantly higher prevalence of instability (17.9 vs. 50%; p < 0.0001). 47.2% of the patients with anxiety disorders presented with instability symptoms (p = 0,01). Patients older than 65 showed a significantly higher percentage of residual symptoms (23.3 vs. 34.8%; p = 0.03). CONCLUSIONS: Persistence of residual symptoms 1 month after the acute BPPV can be associated with certain risk factors that should be taken into consideration (age, number of repositioning maneuvers needed, anxiety and/or depressive disorders). These patients could benefit of treatment with vestibular rehabilitation.
OBJECTIVES: To evaluate the prevalence and management of residual symptoms in recovered BPPVpatients. METHODS: We performed a retrospective study on BPPVpatients of any of the three semicircular canals. Exclusion criteria were multiple-canal BPPV, refractory BPPV, central nervous system pathologies or other vestibular diseases. Patients were treated with repositioning maneuvers until the vertigo disappeared and evaluated for symptoms of instability at 1 month after resolution. A dynamic computerized posturography was then performed on every patient complaining of residual instability. We analyzed demographic data, the affected semicircular canal, number of repositioning maneuvers, presence of anxiety disorders, and we correlated these variables with the presence of residual disequilibrium 1 month after vertigo resolution. RESULTS: We included 361 patients. Residual disequilibrium was found in 107 patients (29.6%) with no significant difference between the rates associated with the three semicircular canals (p = 0.73). The group who needed more than one repositioning maneuver (1 maneuver-229 patients, ≥ 2maneuvers-132 patients) showed a significantly higher prevalence of instability (17.9 vs. 50%; p < 0.0001). 47.2% of the patients with anxiety disorders presented with instability symptoms (p = 0,01). Patients older than 65 showed a significantly higher percentage of residual symptoms (23.3 vs. 34.8%; p = 0.03). CONCLUSIONS: Persistence of residual symptoms 1 month after the acute BPPV can be associated with certain risk factors that should be taken into consideration (age, number of repositioning maneuvers needed, anxiety and/or depressive disorders). These patients could benefit of treatment with vestibular rehabilitation.
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Authors: M von Brevern; A Radtke; F Lezius; M Feldmann; T Ziese; T Lempert; H Neuhauser Journal: J Neurol Neurosurg Psychiatry Date: 2006-11-29 Impact factor: 10.154
Authors: Augusto Pietro Casani; Elena Navari; Roberto Albera; Giuseppe Agus; Giacinto Asprella Libonati; Giuseppe Chiarella; Nicola Lombardo; Vincenzo Marcelli; Giovanni Ralli; Leonardo Scotto di Santillo; Roberto Teggi; Pasquale Viola; Luigi Califano Journal: Clin Pharmacol Date: 2019-08-01