Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Humans ; Semicircular Canals ; Vertigo

Dizziness is one of the most frequent symptoms encountered by a physician. Moreover, the term denotes different sensations for different people. It is essential to clarify what the patient means by asking for examples. There are several common subgroups of dizziness ; vertigo, multisensory dizziness, presyncopal lightheadedness, psychophysiological dizziness, etc. There are many causes of dizziness ; labyrinthine disorders including benign paroxysmal positional vertigo, eight cranial nerve disorders including vestibuloneuronitis, brainstem stroke, cerebellar and temporal lesions. The new diagnostic tools-rotating chair test, videooculography, computerized dynamic posturography have been introduced in assessing the dizziness. Systemic approach is essential for diagnosis of dizziness.
Benign Paroxysmal Positional Vertigo ; Brain Stem Infarctions ; Cranial Nerve Diseases ; Diagnosis ; Dizziness* ; Humans ; Sensation ; Vertigo

Posttraumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral, and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of posttraumatic vertigo; benign paroxysmal positional vertigo, temporal bone fracture, perilymphatic fistula, labyrinthine concussion, posttraumatic hydrops, and cervical vertigo. Since the differential diagnosis of the posttraumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of posttraumatic vertigo were described according to the current literature.
Benign Paroxysmal Positional Vertigo ; Craniocerebral Trauma ; Diagnosis, Differential ; Edema ; Fistula ; Head ; Neck ; Temporal Bone ; Vertigo

OBJECTIVE: To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV). METHOD: One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test. RESULT: The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT. CONCLUSION The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Movements ; Humans ; Posture ; Rotation ; Semicircular Canals ; Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common type of positional vertigo. A canalolithiasis-type of BPPV involving the lateral semicircular canal (LSCC) shows a characteristic direction-changing positional nystagmus (DCPN) which beats towards the lower ear (geotropic) on turning the head to either side in a supine position. Because geotropic DCPN in LSCC canalolithiasis is transient with a latency of a few seconds, the diagnosis can be challenging if geotropic DCPN is persistent without latency. The concept of “light cupula” has been introduced to explain persistent geotropic DCPN, although the mechanism behind it requires further elucidation. In this review, we describe the characteristics of the nystagmic pattern in light cupula and discuss the current evidence for possible mechanisms explaining the phenomenon.
Benign Paroxysmal Positional Vertigo ; Diagnosis ; Ear ; Head ; Nystagmus, Physiologic ; Semicircular Canals ; Supine Position ; Vertigo

BACKGROUND AND OBJECTIVES: The early assessment of treatment is not done for benign paroxysmal positional vertigo (BPPV) since the well-known phenomenon of fatigability after a repeated positional test can mimic successful treatment. The aim of this study is to evaluate the clinical implication of ‘fatigability’ after Epley maneuver and to identify the therapeutic efficacy of Epley maneuver in posterior canal BPPV (PC-BPPV). SUBJECTS AND METHOD: This study was prospectively conducted by two dizziness clinics on 51 consecutive patients diagnosed with PC-BPPV. All patients included in the study received Epley maneuver treatment. The therapeutic results were reassessed immediately after a single trial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm the fatigability of diagnostic procedure immediately after treatment. If the treatment was not successful after 30 minutes, Epley maneuver was repeatedly performed until complete resolution. RESULTS: Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigo nor nystagmus during the positional test. All patients demonstrated complete resolution after receiving one to three Epley maneuvers on the day of diagnosis. ‘Fatigability (false negative result)’ was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observed after 30 minutes but not identified immediately after the first Epley maneuver. CONCLUSION: The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Considering the possibility of fatigability when reassessment is performed immediately after therapeutic maneuver, clinicians should avoid assessing the outcome immediately after treatment in patients with PC-BPPV.
Benign Paroxysmal Positional Vertigo* ; Diagnosis ; Dizziness ; Fatigue ; Humans ; Methods ; Prospective Studies ; Vertigo

To explore the value of items for the Chinese version of Dizziness Handicap Inventory (DHI) in differential diagnosis of benign paroxysmal positional vertigo (BPPV) in patients with vertigo or dizziness first coming to the outpatient clinic.
 Methods: A total of 322 patients with vertigo or dizziness, who came from Nanfang Hospital, Southern Medical University, were enrolled from April 2016 to February 2017. The Chinese version of DHI and Visual Analogue Scale (VAS) were completed by themselves. After detailed vestibular function examination, the patients were divided into a BPPV group, a normal vestibular group, and a abnormal vestibular group.
 Results: The score of DHI-2 in the BPPV group was 5.52±2.10, which was higher than that in the normal vestibular group (3.94±2.91)(t=3.847, P<0.01) and the abnormal vestibular group (4.17±2.74)(t=4.149, P<0.01). There were significant differences in the DHI-2 among the 3 groups (F=9.870, t=4.515, P<0.01). The score of DHI-item 13 in the BPPV group was 3.09±1.39, which was higher than that in the normal vestibular group (1.97±1.63)(t=4.515, P<0.01) and the abnormal vestibular group (1.95±1.70)(t=5.305, P<0.01). There were significant differences in the DHI-item 13 among the 3 groups (F=16.402, P<0.01). There was significant difference in VAS scores among the 3 groups (P<0.05). However, the t-test analysis showed that there was significant difference between the BPPV group and the vestibular abnormal group (P<0.05), while there was no significant difference between the BPPV group and the vestibular normal group (P>0.05).
 Conclusion: DHI-2 and DHI-item 13 should be included in the inquiry of disease history at the time of first diagnosis, which can be used to identify patients with BPPV quickly and effectively.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Diagnosis, Differential ; Diagnostic Tests, Routine ; standards ; Dizziness ; diagnosis ; Humans

BPPV is the most common cause of dizziness in adults, and the symptoms, causes, behavior of adult patients are clearly defined. Pregnant woman may also suffer from BPPV. To our knowledge, there are few reports on BPPV in pregnant women. In this paper, the clinical characteristics and results of 3 pregnant women with BPPV are reported.
Adult ; Benign Paroxysmal Positional Vertigo ; diagnosis ; Dizziness ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; diagnosis

OBJECTIVE: To investigate the diagnosis applying effects of ocular vestibular evoked myogenic potentials(oVEMP) in peripheral BPPV disease. METHOD: During September 2012 to January 2015, we selected 80 healthy people in our hospital medical center as the control group, choose the same period of primary benign paroxysmal positional vertigo as the observation group of 80 patients. Two groups were carried out fully functional auditory evoked potential analysis, determination of oVEMP and cervical vestibular evoked myogenic potentials (cVEMP) anomaly amplitude threshold, P1 latencies, N1 incubation period. RESULT: The cVEMP abnormal rate in the observation group was 28.8%, the oVEMP abnormal rate was 38.8%, while cVEMP and oVEMP abnormal rates in the control group was 1.3% and 2.5% respectively that compared to significant differences between the two groups (P < 0.05). The oVEMP test amplitude in the observation group was (5.98 ± 2.15) µv, the N1 incubation period was (10.03 ± 0.76)ms, while the control group were (4.09 ± 2.11)µv and (11.67 ± 0.78) ms that compared difference were statistically significant (P < 0.05). The cVEMP test amplitude in the observation group was (154.8 ± 43.9)2 µv, while the control group was (180.49 ± 45.34)µv, compared the difference was statistically significant (P < 0.05). CONCLUSION Paroxysmal positional vertigo patients ocular vestibular evoked myogenic potentials abnormal rate is relatively high, the utricle dysfunction for more severe than the balloon can be the subject of an objective function of the ear stone judgment, judgment in favor of the disease.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Case-Control Studies ; Humans ; Saccule and Utricle ; physiopathology ; Vestibular Evoked Myogenic Potentials

OBJECTIVE: To evaluate the effect of the vestibular diagnosis and treatment system (SRM-IV ) in diagnosis and treatment of patients with benign paroxysmal positional vertigo (BPPV). METHOD: Patients who were diagnosed as BPPV by SRM-TV in the clinic of our hospital from November 2013 to October 2014 were retrospectively analyzed in this study. RESULT: Among 425 suspected cases, 230 BPPV-positive patients were diagnosed including 131 cases of posterior SC (57.0%), 95 cases of horizontal SC (41.3%) and 4 cases of more than two SC (1.7%). The cure rate by SRM-V was 94.6% and the effective rate was 100.0%. The relapsed occurred in 10 patients (4.8%), which contained 4 men and 6 women. CONCLUSION SRM-V can realize 360° reasonable repositioning procedure while Canalish reposition procedure cannot. SRM-V can improve both the corrective rate of diagnosis and the cure rate, especially for the patients who suffered from complex BPPV.
Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Female ; Humans ; Male ; Patient Positioning ; Retrospective Studies ; Vestibule, Labyrinth ; physiopathology