Benign Paroxysmal Positional Vertigo. Clinical Epidemiology and Pathophysiology.

Takeda, Noriaki

doi:10.5631/jibirin.94.763

Cited by 10 publications

(1 citation statement)

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“…Previous studies have also reported that BPPV is more common in women. 13,14 Peak age of BPPV onset in this study was in 60s and 70s and patients in these age groups accounted for approximately 50% of all patients. Uno et al also reported that BPPV was most common in individuals aged 60 to 79 years.…”

Section: Discussionmentioning

confidence: 76%

Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness

Masaki

2023

International Journal of Practical Otolaryngology

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Persistent postural-perceptual dizziness (PPPD) is a chronic dizziness disorder that is newly listed in the World Health Organization (WHO)'s International Classification of Diseases (ICD-11) revised in 2018. In this study, I selected definite cases of the first occurrence of benign paroxysmal positional vertigo (BPPV) among vertigo patients who visited our clinic in the past 1 year, and retrospectively reviewed the age at the first visit, gender, affected side, previous medical conditions, type of BPPV, and their tendency toward transition to PPPD. Eligible patients were new first-ever cases of BPPV who visited our clinic during the 1-year period from June 1, 2020, to May 31, 2021, and who met the diagnostic criteria for BPPV established by the Japan Society for Equilibrium Research. There were 311 cases, including 120 men and 191 women, with a male:female ratio of 1:1.6; hence, the majority of patients were women. The mean age ± standard deviation was 60.7 ± 17.8 years. Men ranged in age from 14 to 88 years, with a mean age of 64.2 ± 16.3 years. Women ranged in age from 11 to 90 years, with a mean age of 58.5 ± 18.5 years. Thus, the average age of the men was higher. As for the type of BPPV, there were 172 cases of posterior semicircular canal-type BPPV (canalolithiasis), 79 cases of lateral semicircular canal-type BPPV (canalolithiasis), and 60 cases of lateral semicircular canal-type BPPV (cupulolithiasis), with the posterior semicircular canal-type BPPV (canalolithiasis) being the most common. In regard to the affected side, the right side was affected in 164 cases and the left side in 147 cases; thus, involvement of the right side was more common. The time to remission was less than 0.5 months in 86 cases, less than 1 month in 69 cases, less than 2 months in 50 cases, less than 3 months in 22 cases, and more than 3 months in 57 cases. Remission was achieved in less than 3 months in 72.9% of cases. The course remained unknown in 27 cases, as the patients discontinued their clinic visits. There was only one case of a 75-year-old man and one case of a 70-year-old woman who transitioned to PPPD. Both cases had left-sided posterior semicircular canal-type BPPV (canalolithiasis). The man had underlying hypertension, while the woman had underlying hypertension and diabetes mellitus. The rate of transition from BPPV to PPPD was 0.6% when cases with an unknown course were included, and the rate was as low as 0.7% when cases with an unknown course were excluded. Thus, the frequency of transition from BPPV to PPPD is low.

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Section: Discussionmentioning

confidence: 76%

Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness

Masaki

2023

International Journal of Practical Otolaryngology

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Intratympanic gentamicin instillation therapy to long-lasting benign paroxysmal positional vertigo following idiopathic sudden hearing loss: a case report

Sakata¹,

Nakahara²,

Murofushi³

2008

Equilibrium Res

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Intratympanic instillation of gentamicin is currently a well-established treatment for intractable vertigo in patients with Meniere's disease. There are, however, only a few reports of this therapy in patients with non-Meniere type of vertigo. We report the case of a 68-year-old woman with the lateral semicircular canal type of benign paroxysmal positional vertigo (BPPV) following right idiopathic sudden hearing loss. The patient was annoyed by the positional vertigo for one and a half years and was successfully treated by intratympanic gentamicin instillation. She had profound hearing loss on the right side and direction-changing apogeotropic positional nystagmus. Her caloric response on the right side was severely decreased (canal paresis 80%). Intratympanic gentamicin instillation therapy was undertaken (30 mg/ml/day 5 days), following which her positional vertigo was abolished. We propose that intratympanic instillation of gentamicin may also be applicable to selected patients with long-lasting BPPV.

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Canal Occlusion Surgery for Intractable Benign Paroxysmal Positional Vertigo

Yoshinami¹,

Kitahara²,

Imai³

et al. 2009

Equilibrium Res

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Benign paroxysmal positional vertigo (BPPV) usually resolves in the natural course. Furthermore, therapeutic maneuvers have been reported to accelerate its resolution. However, some patients are annoyed by persistent dizziness and positional nystagmus in their daily lives after conservative treatments, resulting in psychological problems. We have finally identified a surgical treatment strategy for such patients with intractable BPPV, i.e., canal occlusion or canal plugging surgery.We encountered a 28 year-old-man who was diagnosed as having posterior semicircular canal type BPPV, identified by 3 D-eye rotation axis analysis during Dix-Hallpike positioning. He had suffered from persistent positional vertigo for more than 10 years despite undergoing various kinds of non-surgical treatments. We performed posterior semicircular canal occlusion surgery for intractable BPPV in this patient, which resulted in successful resolution of the complaints and nystagmus. There were no significant side effects, including sensorineural hearing loss, after the operation.We would like to conclude that the safe and effective option of canal occlusion surgery should be considered for intractable BPPV, although such a condition is very rare (0.23% in our case series). We would also like to emphasize that 3 D-eye rotation axis analysis is quite helpful for identifying the affected semicircular canal in BPPV patients.

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Benign Paroxysmal Positional Vertigo. Clinical Epidemiology and Pathophysiology.

Cited by 10 publications

References 0 publications

Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness

Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness

Intratympanic gentamicin instillation therapy to long-lasting benign paroxysmal positional vertigo following idiopathic sudden hearing loss: a case report

Canal Occlusion Surgery for Intractable Benign Paroxysmal Positional Vertigo

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