Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Humans

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

BACKGROUND AND OBJECTIVES: Although repositioning maneuvers have shown remarkable success rate in treatments of benign paroxysmal positional vertigo (BPPV), the high recurrence rate of BPPV has been an important issue. The aims of present study were to examine the effects of otolith dysfunction on BPPV recurrence rate and to describe the effect of vestibular rehabilitation exercises on BPPV recurrence in BPPV patients with concomitant otolith dysfunction. SUBJECTS AND METHODS: Forty-five BPPV patients included in this study (three groups). Patients in group 1 had no otolith dysfunction and patients in groups 2 and 3 had concomitant otolith dysfunction. Otolith dysfunction was determined with ocular/cervical vestibular evoked myogenic potential (oVEMP and cVEMP) abnormalities. Epley’s maneuver was performed for the patients in all groups but patients in group 3 also received a 2-month vestibular rehabilitation program (habituation and otolith exercises). RESULTS: This study showed that BPPV recurrent rate was significantly higher in patients with otolith dysfunction in comparison to the group 1 (p < 0.05). Vestibular rehabilitation resulted in BPPV recurrence rate reduction. Utricular dysfunction showed significant correlation with BPPV recurrence rate. CONCLUSIONS: Otolith dysfunction can increase BPPV recurrence rate. Utricular dysfunction in comparison to saccular dysfunction leads to more BPPV recurrence rate. Vestibular rehabilitation program including habituation and otolith exercises may reduce the chance of BPPV recurrence.
Benign Paroxysmal Positional Vertigo ; Exercise ; Humans ; Otolithic Membrane ; Recurrence ; Rehabilitation

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder that causes vertigo. Study of BPPV has dramatically rapid progress in recent years. We analyze the BPPV growth METHOD: We searched the international data quantity year by year in database of PubMed, ScienceDirect and WILEY before 2014 respectively, then we searched the domestic data quantity year by year in database of CNKI, VIP and Wanfang Data before 2015 by selecting "Benign paroxysmal positional vertigo" as the keywords. Then we carried out regression analysis with the gathered results in above databases to determine data growth regularity and main factors that affect future development of BPPV. Also, we analyzes published BPPV papers in domestic and international journals. RESULT: PubMed database contains 808 literatures, ScienceDirect contains 177 database and WILEY contains 46 literatures, All together we collected 1 038 international articles. CNKI contains 440 literatures, VIP contains 580 literatures and WanFang data contains 449 literatures. All together we collected 1 469 domestic literatures. It shows the rising trend of the literature accumulation amount of BPPV. The scattered point diagram of BPPV shows an exponential growing trend, which was growing slowly in the early time but rapidly in recent years. CONCLUSION It shows that the development of BPPV has three stages from international arical: exploration period (before 1985), breakthrough period (1986-1998). The deepening stage (after 1998), Chinese literature also has three stages from domestic BPPV precess. Blank period (before the year of 1982), the enlightenment period (1982-2004), the deepening stage (after the year of 2004). In the pregress of BPPV, many outsantding sccholars played an important role in domestic scitifction of researching, which has produced a certain influence in the worldwide.
Benign Paroxysmal Positional Vertigo ; Bibliometrics ; Databases, Factual ; Humans

OBJECTIVE: The purpose of this study was to identify the influence of sleep position on benign paroxysmal positional vertigo (BPPV). METHODS: Four hundred sixty patients diagnosed as posterior or horizontal canal BPPV were analyzed retrospectively. All patients were asked about their preferred sleep positions among the following four choices: supine, right or left lateral, or no predominant side via questionnaire at initial visit and after 1month. Patients were classified into two groups: affected side group meaning that the patient preferred to sleep ipsilateral to the affected ear and other position group including all positions other than lying lateral to the affected side after treatment. We analyzed the change in the sleep pattern after treatment and compared the recurrence rate between the two groups. RESULTS: Our study included 244 patients with posterior canal BPPV (PC-BPPV) and 216 patients with horizontal canal BPPV (HC-BPPV). Statistically significant correlation was demonstrated between sleep position side and the affected side by BPPV. The number of patients who slept on the affected side by BPPV decreased, while the number of patients who slept on the healthy side increased significantly after treatment. There was no statistically significant difference in the recurrence rate between the two groups. CONCLUSION: There was significant correlation between the sleep position side and the affected side in PC-BPPV and HC-BPPV. The patient had a tendency to avoid lying lateral to the affected side by BPPV during sleep after treatment, however the change in sleep position did not influence the recurrence rate of BPPV.
Benign Paroxysmal Positional Vertigo ; Deception ; Ear ; Humans ; Recurrence ; Retrospective Studies

OBJECTIVES: Patients, who showed persistent geotropic-direction changing positional nystagmus (p-DCPN) tend to have different clinical manifestations from those who showed transient geotropic DCPN (t-DCPN). We investigated the clinical characteristics between p-DCPN and t-DCPN patients, and its recovery rate after canalith repositioning procedure (CRP). METHODS: Based on the duration of nystagmus, 117 geotropic DCPN patients were classified to 2 groups, p-DCPN and t-DCPN. Barbeque maneuver had been introduced towards the opposite direction of null plane for the p-DCPN patients, and to the opposite direction of stronger nystagmus for the t-DCPN patients. RESULTS: Seventy-four patients showed t-DCPN and 43 patients were classified to the p-DCPN cases. No p-DCPN patient showed prompt improvement after the 1st canalolith reposition therapy. Among the t-DCPN patients, 18 canal switch cases were found , but, there was no canal switch cases found among the p-DCPN The CRP has showed less effective for the p-DCPN patients than the t-DCPN patients (after the 1st CRP, 37 in 74 improved, p < 0.001). CONCLUSIONS: Due to its distinguishing clinical manifestation, p-DCPN may have different pathogenesis and clinical mechanisms from t-DCPN. And for the p-DCPN patients, the CRP seems not an efficient treatment compared to the t-DCPN patients. Further study with larger number of enrolled subjects is necessary.
Benign Paroxysmal Positional Vertigo ; Follow-Up Studies ; Humans ; Nystagmus, Physiologic

Benign Paroxysmal Positional Vertigo ; Humans ; Vitamin D ; Vitamins

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

OBJECTIVETo evaluate the efficacy of the modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo.

METHODSThe randomized controlled trials (RCT) about modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo from January 1985 to July 2013 were searched in CNKI,OVID, PubMed, CBM, EMBASE, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-analyses were conducted by using RevMan 5.1 software.

RESULTSA total of six RCTs were included. Among the 453 patients involved, 232 patients were in the modified Epley maneuver group, while the other 221 patients were in the modified Semont maneuver group. The results of meta-analyses showed that the efficacy of the modified Epley maneuve group was superior to that of the modified Semont maneuver group in one-week cure rate[OR = 3.25, 95%CI (2.08, 5.10) , P < 0.01], one-week efficient [OR = 4.72, 95%CI (1.16, 19.15) , P = 0.03], with significant differences. There was no significant difference between the two groups in three-months cure rate [OR = 2.10, 95%CI (0.57, 7.75) , P = 0.27], incidence of adverse reactions [OR = 0.82, 95%CI(0.44, 1.52), P = 0.53] and relapse rate [OR = 0.56, 95%CI (0.20, 1.57) , P = 0.27].

CONCLUSIONSBased on the current studies, modified Epley maneuver is superior to modified Semont maneuver in quicking relief posterior canal benign paroxysmal positional vertigo symptoms, but the long-term efficacy, recurrence rate and incidence of adverse reactions had no significant difference. For the quality restrictions and possible publication bias of the included studies, more double blind RCTs with high quality are required to further assess the effects.

Benign Paroxysmal Positional Vertigo ; therapy ; Double-Blind Method ; Exercise Movement Techniques ; methods ; Humans ; Recurrence ; Vertigo

OBJECTIVETo discuss the objective characteristics and mechanism of nystagmus direction, intensity and time in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) .

METHODSA total of 233 patients with HSC-BPPV, whereas 179 horizontal semicircular canalithasis (HSC-Can) and 54 horizontal semicircular cupulolithiasis (HSC-Cup) were involved respectively. The induced nystagmus in roll tests recorded by video-nystagmograph(VNG) , whose direction, intensity and time characteristics were compared in various BPPV.

RESULTSHorizontal nystagmus was both induced by turning left or right in HSC-BPPV roll tests. The direction of the induced nystagmus was the same with turning in HSC-Can. The latency, duration time and intensity ([AKx(-)D] ± s) turning to lesion and normal side were (1.922 ± 1.501)s and (1.447 ± 0.855)s, (25.620 ± 10.409)s, and (22.110 ± 10.931)s, (56.441 ± 33.168)°/s and (24.239 ± 13.892) °/s in HSC-Can. The latency, duration time and intensity turning to lesion side were larger than normal side (t = 3.715, 15.219 and 4.070, P < 0.01) , the difference was statistically significant, and the intensity rate was about 2: 1. The direction of the induced nystagmus was opposite to turning in HSC-Cup. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2: 1, the difference was statistically significant (t = -7.634, P < 0.01) . While the latency and intensity of turning to lesion side in HSC-Can were larger than turn to normal side in HSC-Cup, and the difference detected no statistically significant difference (t = 1.554 and 0.305, P > 0.05).

CONCLUSIONSThe induced nystagmus intensity of head to two sides in roll tests for HSC-BPPV both follow Ewald's law, and the ratio between stronger and weaker are both 2: 1. These nystagmus parameters of VNG in roll tests are an objective guideline for BPPV diagnosis.

Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; Electronystagmography ; Head ; Humans ; Nystagmus, Pathologic ; complications ; diagnosis ; Semicircular Canals ; Vertigo