Camilla Martens1,2, Frederik Kragerud Goplen3,4, Torbjørn Aasen3, Karl Fredrik Nordfalk5, Stein Helge Glad Nordahl3,4. 1. Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway. camillamartens@gmail.com. 2. Department of Clinical Medicine, University of Bergen, Bergen, Norway. camillamartens@gmail.com. 3. Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway. 4. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 5. Department of Otorhinolaryngology and Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.
Abstract
PURPOSE: Benign paroxysmal positional vertigo (BPPV) is diagnosed and divided into subtypes based on positioning vertigo and nystagmus. Whether these subtypes entail any significant differences in patient-reported symptoms; is yet not known. Such differences may have clinical and therapeutic consequences. Our aim was to assess dizziness handicap and clinical characteristics of posterior and lateral canal BPPV. METHODS: This prospective observational multicentre study analysed consecutive patients with BPPV, confirmed by standardized procedures including videonystagmography under diagnostic manoeuvres in a biaxial rotational chair. Patients were screened for other neurological and otological disorders. OUTCOMES: Dizziness handicap inventory (DHI), posterior vs. lateral canal involvement. FACTORS: age, gender, positional nystagmus intensity (maximum slow-phase velocity), symptom duration, 25-hydroxyvitamin D-level and traumatic aetiology. RESULTS: 132 patients aged 27-90 (mean 57, SD 13) years were included. Higher DHI scores were associated with lateral canal BPPV [95% CI (1.59-13.95), p = 0.01] and female gender [95% CI (0.74-15.52), p = 0.03]. Lateral canal BPPV was associated with longer symptom duration [OR 1.10, CI (1.03-1.17), p = 0.01] and lower 25-hydroxyvitamin D-levels [OR 0.80, CI (0.67-0.95), p = 0.03]. There was no correlation between DHI scores and nystagmus intensity. CONCLUSIONS: This study suggests that patients with lateral canal BPPV have increased patient-perceived disability, lower vitamin D-levels and longer duration of symptoms. This subtype might therefore require closer follow-up. Patient-perceived disability is not related to positional nystagmus intensity.
PURPOSE:Benign paroxysmal positional vertigo (BPPV) is diagnosed and divided into subtypes based on positioning vertigo and nystagmus. Whether these subtypes entail any significant differences in patient-reported symptoms; is yet not known. Such differences may have clinical and therapeutic consequences. Our aim was to assess dizziness handicap and clinical characteristics of posterior and lateral canal BPPV. METHODS: This prospective observational multicentre study analysed consecutive patients with BPPV, confirmed by standardized procedures including videonystagmography under diagnostic manoeuvres in a biaxial rotational chair. Patients were screened for other neurological and otological disorders. OUTCOMES: Dizziness handicap inventory (DHI), posterior vs. lateral canal involvement. FACTORS: age, gender, positional nystagmus intensity (maximum slow-phase velocity), symptom duration, 25-hydroxyvitamin D-level and traumatic aetiology. RESULTS: 132 patients aged 27-90 (mean 57, SD 13) years were included. Higher DHI scores were associated with lateral canal BPPV [95% CI (1.59-13.95), p = 0.01] and female gender [95% CI (0.74-15.52), p = 0.03]. Lateral canal BPPV was associated with longer symptom duration [OR 1.10, CI (1.03-1.17), p = 0.01] and lower 25-hydroxyvitamin D-levels [OR 0.80, CI (0.67-0.95), p = 0.03]. There was no correlation between DHI scores and nystagmus intensity. CONCLUSIONS: This study suggests that patients with lateral canal BPPV have increased patient-perceived disability, lower vitamin D-levels and longer duration of symptoms. This subtype might therefore require closer follow-up. Patient-perceived disability is not related to positional nystagmus intensity.
Authors: Jose A Lopez-Escamez; Maria J Gamiz; Antonio Fernandez-Perez; Manuel Gomez-Fiñana Journal: Eur Arch Otorhinolaryngol Date: 2004-11-16 Impact factor: 2.503
Authors: Richard A Roberts; Harvey Abrams; Melanie K Sembach; Jennifer J Lister; Richard E Gans; Theresa Hnath Chisolm Journal: Ear Hear Date: 2009-06 Impact factor: 3.570