Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment

Motin, M.; Keren, Ofer; Groswasser, Zeev; Gordon, Carlos R.

doi:10.1080/02699050400013600

Cited by 65 publications

(68 citation statements)

References 12 publications

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“…BPPV may occur relatively commonly after trauma or traumatic brain injury. 98,131 Posttraumatic BPPV is most likely to involve the posterior semicircular canal, and studies indicate that posttraumatic BPPV is significantly more likely to require repeated CRP (up to 67% of cases) for resolution, as compared with nontraumatic forms (14% of cases). 132,133 Because posttraumatic BPPV may be more refractory and/or bilateral, thus requiring specialized treatment, a history of head trauma preceding a clinical diagnosis of BPPV should be elicited.…”

Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

“…132,133 Because posttraumatic BPPV may be more refractory and/or bilateral, thus requiring specialized treatment, a history of head trauma preceding a clinical diagnosis of BPPV should be elicited. 131,134 Although dizziness in the setting of multiple sclerosis may have a variety of etiologies, studies of acute vertigo occurring in multiple sclerosis report that a substantial number of patients may have BPPV with a positive DixHallpike maneuver and successful response to a CRP. 111,135 These studies support that care should be taken to not miss a diagnosis of BPPV among patients with CNS disorders, as they may be successfully diagnosed and treated with CRP for BPPV.…”

Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

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Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

566

776

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Objective. This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV.Purpose. The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.Action Statements. The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate...

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Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

Section: Action Statement Profile For Statement 2bmentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

566

776

View full text Add to dashboard Cite

show abstract

“…Although there is a strong evidence base and clinical practice guidelines (Bhattacharyya et al, 2008) for the assessment and treatment of BPPV in the general population, there are only a handful of studies describing the characteristics and presentation of post-TBI BPPV (Davies & Luxon, 1995;Gordon, Levite, Joffe, & Gadoth, 2004;Katsarkas, 1999) and only two studies (Ahn et al, 2011;Motin, Keren, Groswasser, & Gordon, 2005) describing its treatment in this population. Motin et al assessed 150 consecutive admissions to a rehabilitation facility after severe TBI (Motin et al, 2005).…”

mentioning

confidence: 98%

“…Motin et al assessed 150 consecutive admissions to a rehabilitation facility after severe TBI (Motin et al, 2005). They identified 20 patients with complaints of vertigo, and 10 of these were diagnosed with posterior canal BPPV based on the DHP-M. Ahn et al conducted a retrospective analysis of the records of 192 consecutive patients with head trauma and vertigo treated at their tertiary referral neurotology and dizziness clinic (Ahn et al, 2011).…”

mentioning

confidence: 99%

Treating Benign Paroxysmal Positional Vertigo in the Patient With Traumatic Brain Injury

Ouchterlony

Masanic

Michalak

et al. 2016

Journal of Neuroscience Nursing

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“…6 About 13% of traumatic brain injury patients complain of positional vertigo and onehalf have BPPV responsive to treatment. 7 BPPV owing to trauma is usually apparent within 1 week of head trauma as long as the patient has been moving sufficiently to provoke symptoms. 8 Adding to the challenge of diagnosis, acute vestibular neuritis can be associated with BPPV, possibly owing to inflammatory effects in the labyrinth or by affecting labyrinthine perfusion.…”

Section: Epidemiologymentioning

confidence: 99%