Clinical features and outcomes of benign recurrent vertigo: A longitudinal study

Pan, Qi; Zhang, Yixin; Zhang, Shanshan; Wang, Weiheng; Jiang, Haojie; Fan, Yulan; Zhou, Jiying

doi:10.1111/ane.13214

Cited by 15 publications

(16 citation statements)

References 28 publications

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“…Similar rates of accompanying auditory symptoms (3-14%) have been reported for BRV patients without migraine before. Furthermore, the relative frequencies of photophobia or phonophobia (5.7% each) and non-migrainous headache (14%) in our study were similar to values from the literature (13,16,17,23).…”

Section: Accompanying Symptomssupporting

confidence: 90%

“…The vestibular syndrome of RVS-NOS seems to be stable over time rather than a transitory condition converting into another vertigo syndrome. Previous studies reported that the diagnosis of patients with BRV/RV had to be changed to migraine in only 2 to 7.5% of cases and to MD in only 1 to 4% over median follow-up times between 31 and 63 months (12,17,29). This is in line with the results from our study where the mean duration of the vestibular syndrome before the patients' first visit in a neurotology clinic was not significantly different between patients with RVS-NOS (5.40 ± 6.10 years) as compared to VM (5.26 ± 6.59 years) or MD (7.63 ± 8.09 years) indicating a rather stable vestibular syndrome not changing over the years.…”

Section: Rationale Of the Present Studymentioning

confidence: 99%

“…Some authors (8,12,16) excluded patients with head-motion triggered vertigo. Brantberg and Baloh (16), van Esch (13) and van Leeuwen (15) included only patients with spontaneous vertigo, while Pan (17) chose a broader definition of "vestibular symptoms of moderate or severe intensity" not necessarily occurring spontaneously.…”

Section: Introductionmentioning

confidence: 99%

“…With the classification of VM as a separate vestibular disorder, migraine headaches during an attack or a history of migraine became exclusion criteria for BRV/RV (15). Still, around 20% of patients with BRV / RV report non-migrainous headache as an accompanying symptom of vertigo attacks (13,17).…”

Section: Introductionmentioning

confidence: 99%

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Recurrent Vestibular Symptoms Not Otherwise Specified: Clinical Characteristics Compared With Vestibular Migraine and Menière's Disease

et al. 2021

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Despite the huge progress in the definition and classification of vestibular disorders within the last decade, there are still patients whose recurrent vestibular symptoms cannot be attributed to any of the recognized episodic vestibular syndromes, such as Menière's disease (MD), vestibular migraine (VM), benign paroxysmal positional vertigo (BPPV), vestibular paroxysmia, orthostatic vertigo or transient ischemic attack (TIA). The aim of the present international, multi-center, cross-sectional study was to systematically characterize the clinical picture of recurrent vestibular symptoms not otherwise specified (RVS-NOS) and to compare it to MD and VM. Thirty-five patients with RVS-NOS, 150 patients with VM or probable VM and 119 patients with MD were included in the study. The symptoms of RVS-NOS had been present for 5.4 years on average before inclusion, similar to VM and MD in this study, suggesting that RVS-NOS is not a transitory state before converting into another diagnosis. Overall, the profile of RVS-NOS vestibular symptoms was more similar to VM than MD. In particular, the spectrum of vestibular symptom types was larger in VM and RVS-NOS than in MD, both at group comparison and the individual level. However, in contrast to VM, no female preponderance was observed for RVS-NOS. Positional, head-motion and orthostatic vertigo were reported more frequently by patients with RVS-NOS than MD, while external vertigo was more prevalent in the MD group. At group level, the spectrum of attack durations from minutes to 3 days was evenly distributed for VM, while a small peak for short and long attacks in RVS-NOS and a big single peak of hours in MD were discernible. In general, vertigo attacks and associated vegetative symptoms (nausea and vomiting) were milder in RVS-NOS than in the other two disorders. Some patients with RVS-NOS described accompanying auditory symptoms (tinnitus: 2.9%, aural fullness and hearing loss: 5.7% each), migrainous symptoms (photophobia, phonophobia or visual aura in 5.7% each) or non-migrainous headaches (14%), but did not fulfill the diagnostic criteria for MD or VM. Absence of a life time diagnosis of migraine headache and attack duration of <5 min were further reasons not to qualify for VM. In some RVS-NOS patients with accompanying ear symptoms, attack durations of <20 min excluded them from being diagnosed with MD. These findings suggest that RVS-NOS is a stable diagnosis over time whose overall clinical presentation is more similar to VM than to MD. It is more likely to be composed of several disorders including a spectrum of mild or incomplete variants of known vestibular disorders, such as VM and MD, rather than a single disease entity with distinct pathognomonic features.

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Section: Accompanying Symptomssupporting

confidence: 90%

Section: Rationale Of the Present Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recurrent Vestibular Symptoms Not Otherwise Specified: Clinical Characteristics Compared With Vestibular Migraine and Menière's Disease

et al. 2021

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“…We are very grateful for Dr van Leeuwen's valuable comment on our article. 1 Recurrent vertigo is common in clinical work. As early as 1979, Slater firstly used benign recurrent vertigo (BRV) to describe that some adult patients present with recurrent vertigo without neurologic or any auditory symptoms.…”

Section: Reply To: "Clinical Features and Outcomes Of Benign Recurrenmentioning

confidence: 99%

Reply to: “Clinical features and outcomes of benign recurrent vertigo”

Pan

Zhang

et al. 2020

Acta Neurol Scand

Self Cite

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Recurrent vertigo is common in clinical work. As early as 1979, Slater firstly used benign recurrent vertigo (BRV) to describe that some adult patients present with recurrent vertigo without neurologic or any auditory symptoms. 2 In subsequent studies, some scholars found that BRV was closely related to migraine. 3,4 But after the International Headache Association and Barany Association proposed vestibular migraine as an independent entity, 5 BRV now refers only to recurrent vertigo attacks without etiology. To further explore whether BRV is associated with Meniere's disease or vestibular migraine, we conducted this longitudinal study.In the process of collecting patients, we asked patients' medical history in detail, including a detailed history of dizziness or vertigo and migraine-related symptoms, such as whether it was accompanied by pulsatile headache, phonophobia, photophobia, and aura symptoms. Up to now, BRV is still an exclusive diagnosis. First, we excluded patients who met vestibular migraine (ICHD-3 diagnostic criteria), BPPV, and Meniere's disease. We then excluded patients with recurrent vertigo accompanied by photophobia and phonophobia. It is worth mentioning that we had not ruled out patients with recurrent attacks with only phonophobia or photophobia.In this study, patients with transient vertigo attacks (duration <5 minutes) who were not treated with carbamazepine/oxcarbazepine did have difficulty in distinguishing from probable vestibular paroxysmia. 6 However, all patients were examined by dynamic positioning test, and no characteristic positional nystagmus was found.Recently, Lee and coworkers have reported interictal headshaking nystagmus with prolonged time constant in 35 patients with BRV, which suggested that BRV might be a central localization. It is worth mentioning that these patients also have higher high susceptibility to motion sickness. 7In summary, in order to further study the pathophysiological mechanism of BRV, we will strictly control the inclusion criteria in future studies. Meanwhile, we will try to further distinguish BRV from other episodic vestibular disorders through more objective examination.

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Application of clinical indicators in evaluating vestibular compensation efficacy in benign recurrent vestibular vertigo patients with short-term personalized vestibular rehabilitation

Wang,

Lei,

Tian

et al. 2024

Eur Arch Otorhinolaryngol

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Background Short-term personalized vestibular rehabilitation (ST-PVR) can establish stable vestibular compensation. However, there is a lack of a clear definition for clinical indicators that can dynamically reflect the progress of vestibular rehabilitation (VR). Objective To explore the clinical indicators suitable for evaluating the effectiveness of ST-PVR in treating benign recurrent vertigo (BRV). Methods In total, 50 patients diagnosed with BRV were enrolled. All patients received the ST-PVR treatment program. At 2 and 4 weeks after rehabilitation, subjective scales, including the visual analogue scale (VAS), dizziness handicap inventory scale (DHI), activities‐specific balance confidence scale (ABC) and generalized anxiety disorder (GAD-7) were assessed. Objective vestibular function tests were performed. VR grading was determined. Results At 2 weeks after rehabilitation, significant enhancements were observed in VAS, DHI, ABC, GAD-7, UW, vHIT results, and VR grading scores (p < 0.05). The sensory organization test (SOT) results demonstrated statistically significant improvements at 2 weeks and 4 weeks after rehabilitation (p < 0.05). Conclusion and significance Both subjective scales and partial examination results in objective assessment can serve as indicators to dynamically monitor the compensatory process of vestibular function in patients with BRV. The VR efficacy grading score, which incorporates the above indicators, allows for quantification of the changes that occur during the vestibular rehabilitation process.

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Clinical features and outcomes of benign recurrent vertigo: A longitudinal study

Cited by 15 publications

References 28 publications

Recurrent Vestibular Symptoms Not Otherwise Specified: Clinical Characteristics Compared With Vestibular Migraine and Menière's Disease

Recurrent Vestibular Symptoms Not Otherwise Specified: Clinical Characteristics Compared With Vestibular Migraine and Menière's Disease

Reply to: “Clinical features and outcomes of benign recurrent vertigo”

Application of clinical indicators in evaluating vestibular compensation efficacy in benign recurrent vestibular vertigo patients with short-term personalized vestibular rehabilitation

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