Benign Paroxysmal Positional Vertigo in Non-blast-related TBI: A Guide for Audiologists

A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation

“…From a vestibular system evaluation, it is encouraging that of those audiologists who reported altering their diagnostic test battery, Dix Hallpike manoeuvre was the reported test of choice. This is consistent with current recommendations based on the significant prevalence of BPPV in patients with TBI (Ahn et al, 2011; American Speech-Language-Hearing Assocation, n.d.-b; Bhattacharyya et al, 2017; Marshall et al, 2015; Šarkić et al, 2021b). While a universally accepted protocol for traumatic BPPV diagnosis and management does not exist, audiologists should consider the heightened likelihood of bilateral BPPV, multi-canal involvement and the possibility of initial treatment failure in traumatic BPPV (Ahn et al, 2011; Marshall et al, 2015).…”

“…While this is an encouraging finding given that head trauma is the most common cause of acquired BPPV, accounting for 15–20% of all BPPV cases (Baloh, Honrubia, & Jacobson, 1987; Hughes & Proctor, 1997; Katsarkas & Kirkham, 1978), it is important to note that half of the surveyed audiologists either did not expect patients with TBI to present with post-traumatic vestibular pathology or were unsure. This finding is particularly problematic given poorer prognostic features associated with traumatic BPPV (t-BPPV) compared to idiopathic BPPV (Roberts, Gans, Kastner, & Lister, 2005), including greater recurrence rates and greater bilateral vestibular system involvement (Gordon, Levite, Joffe, & Gadoth, 2004; Katsarkas, 1999; Liu, 2012; Šarkić, Douglas, & Simpson, 2021b).…”

“…While a universally accepted protocol for traumatic BPPV diagnosis and management does not exist, audiologists should consider the heightened likelihood of bilateral BPPV, multi-canal involvement and the possibility of initial treatment failure in traumatic BPPV (Ahn et al, 2011; Marshall et al, 2015). For a more detailed account summarising recommendations for audiologists working patients with post-traumatic BPPV, see our recent publication (Šarkić et al, 2021b).…”

A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation

“…From a vestibular system evaluation, it is encouraging that of those audiologists who reported altering their diagnostic test battery, Dix Hallpike manoeuvre was the reported test of choice. This is consistent with current recommendations based on the significant prevalence of BPPV in patients with TBI (Ahn et al, 2011;American Speech-Language-Hearing Assocation, n.d.-b;Bhattacharyya et al, 2017;Marshall et al, 2015;Šarkić et al, 2021b). While a universally accepted protocol for traumatic BPPV diagnosis and management does not exist, audiologists should consider the heightened likelihood of bilateral BPPV, multi-canal involvement and the possibility of initial treatment failure in traumatic BPPV (Ahn et al, 2011;Marshall et al, 2015).…”

“…While this is an encouraging finding given that head trauma is the most common cause of acquired BPPV, accounting for 15-20% of all BPPV cases (Baloh, Honrubia, & Jacobson, 1987;Hughes & Proctor, 1997;Katsarkas & Kirkham, 1978), it is important to note that half of the surveyed audiologists either did not expect patients with TBI to present with post-traumatic vestibular pathology or were unsure. This finding is particularly problematic given poorer prognostic features associated with traumatic BPPV (t-BPPV) compared to idiopathic BPPV (Roberts, Gans, Kastner, & Lister, 2005), including greater recurrence rates and greater bilateral vestibular system involvement (Gordon, Levite, Joffe, & Gadoth, 2004;Katsarkas, 1999;Liu, 2012;Šarkić, Douglas, & Simpson, 2021b).…”