Clinical features of BPPV and their influence on the choice of the doctor’s tactics

Pal'chun, V T; Кryukov, A. I.; Makarov, Sergey

doi:10.17116/otorino2021860414

Cited by 7 publications

(2 citation statements)

References 8 publications

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“…The initial BPPV presentation can be at a variety of healthcare settings, including the emergency room, primary care clinics, or neurology or otolaryngology clinics. 31 One study found that the average time from first referral to BPPV diagnosis was 93 weeks, emphasising the need for oto-neurological skills in primary care settings to allow timely and cost-effective help for patients in need. 32 The role and opinion of healthcare workers in multiple different specialties must be considered when designing guidelines, to ensure expert consensus for clinical diagnosis and management.…”

Section: Discussionmentioning

confidence: 99%

A critical appraisal of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo

et al. 2022

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Background Delays in the diagnosis and therapy of benign paroxysmal positional vertigo can greatly impact quality of life and increase healthcare costs for patients. This study aimed to appraise the quality of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo. Methods A comprehensive database search of clinical practice guidelines was completed up to 30 October 2021. Four independent reviewers used the Appraisal of Guidelines for Research and Evaluation II instrument in the quality appraisal. Results The highest score was in ‘clarity and presentation’ (58.33 ± 22.7). The lowest score was in ‘applicability’ (13.96 ± 30.1). Overall, four clinical practice guidelines were ‘low quality’ and only one guideline was ‘high quality’. Conclusion This review identified a significant lack of quality in clinical practice guideline development for benign paroxysmal positional vertigo, highlighting the need for a more rigorous approach for future guideline development.

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Section: Discussionmentioning

confidence: 99%

A critical appraisal of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo

et al. 2022

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“…Приступы головокружения короткие, длительность не превышает в типичных случаях двух минут, однако они могут сопровождаться вегетативными реакциями различной выраженности. ДППГ обусловлено сочетанным нарушением функции ампулярных рецепторов полукружных каналов, а также отолитовых рецепторов преддверия [2]. Рецепторы макулы утрикулюса, отвечающие за регистрацию линейных ускорений и силы тяжести, содержат в себе отолиты -это кристаллы карбоната кальция размером 10 мкм.…”

Section: резюме _____________________________________________________...unclassified

Central Positional Syndrome Mimics Benign Paroxysmal Positional Vertigo: A Case Report

Кунельская,

Заоева,

Манаенкова

et al. 2023

Оториноларингология. Восточная Европа

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Позиционный нистагм чаще всего возникает вследствие заболевания внутреннего уха – доброкачественного пароксизмального позиционного головокружения (ДППГ). Диагноз устанавливается на основании жалоб и анамнеза пациента, а также выявления характерного нистагма. Несоответствие характеристик нистагма ожидаемым при ДППГ требует исключения других причин позиционного головокружения, в том числе центрального позиционного синдрома. В статье приведен разбор основных характеристик центрального и периферического позиционного нистагма. Описываются основные заболевания, которые могут проявляться позиционным синдромом, а также критерии дифференциальной диагностики центрального и периферического позиционного головокружения. Описан клинический пример центрального позиционного синдрома при вестибулярной мигрени, которая скрывалась под маской доброкачественного пароксизмального позиционного головокружения горизонтального полукружного канала (геотропного типа), а также наш опыт лечения пациентов с мигрень-ассоциированным головокружением. Наглядно объясняется важность сбора анамнеза и правильности оценки результатов, полученных при проведении диагностических позиционных тестов, чтобы не пропустить под маской доброкачественного пароксизмального позиционного синдрома заболевания центральной нервной системы. Positional nystagmus most often occurs due to a disease of the inner ear – benign paroxysmalpositionalvertigo(BPPV).Thediagnosisisestablishedonthebasisofcomplaints and anamnesis of the patient, as well as the identification of a characteristic nystagmus. The discrepancy between the characteristics of nystagmus expected in BPPV requires the exclusion of other causes of positional vertigo, including central positional syndrome. The article presents an analysis of the main characteristics of central and peripheral positional nystagmus. The main diseases that can manifest as positional syndrome are described, as well as criteria for differential diagnosis of central and peripheral positional vertigo. A clinical example of central positional syndrome in vestibular migraine, which was hiding under the mask of benign paroxysmal positional vertigo of the horizontal semicircular channel (geotropic type), is described, and our experience in treating patients with migraine-associated vertigo is presented. The importance of collecting anamnesis and the correctness of evaluating the results obtained during diagnostic positional tests is clearly explained, in order not to miss the diseases of the central nervous system under the guise of benign paroxysmal positional syndrome.

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Clinical and VEMPS Characteristics of Benign Recurrent Vertigo With Cochlear Symptoms and Migraine

Zhang,

Xu,

et al. 2023

Ear Nose Throat J

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Objectives: To explore the clinical manifestations and vestibular-evoked myogenic potential (VEMP) characteristics in patients diagnosed with benign recurrent vertigo (BRV) accompanied by cochlear symptoms or migraine history. Methods: A total of 34 patients were diagnosed with BRV (57 ears) and 30 healthy volunteers (60 ears) were recruited. They were divided into 4 groups: Group A consisted of 17 patients diagnosed as BRV with cochlear symptoms (21 ears), Group B consisted of 11 patients diagnosed as BRV with migraine history (22 ears), and Group C consisted of 7 patients with BRV without cochlear symptoms and migraine history (14 ears). Group D, as a Normal control (NC) group, consisted of 30 healthy volunteers without a history of migraine and cochlear symptoms. Detailed consultations and VEMP testing were performed separately. The VEMPs elicitation rate, amplitude ratio at different frequencies and amplitude statistics were compared and analyzed among the 4 groups. Results: The amplitudes of cervical vestibular evoked myogenic potential (cVEMP) have significant differences between Groups D and A, and Group C, under 500 Hz ( PAD = .017, PBD = .052, PCD = .044), but the amplitudes of cVEMP have significant differences between Groups D and A, and Group B under 1000 Hz, respectively ( PAD = .008, PBD = .020, PCD = .119). The amplitudes of ocular vestibular evoked myogenic potential (oVEMP) have significant differences between Groups D and A, and Group B, under 500 Hz, respectively ( PAD = .029, PBD = .005, PCD = .198). oVEMP amplitudes significantly differ between Groups D and A under 1000 Hz ( PAD = .049, PBD = .079, PCD = .103). The statistical difference was absent in elicit rates of cVEMP and oVEMP between the NC and experimental groups (cVEMP: PAD = .525, PBD = .917, PCD = .374; oVEMP: PAD = .678, PBD = .523, PCD = .427). Moreover, there is no significant difference between the NC group and experimental groups among VEMPs and VEMP frequency amplitude ratio ( P > .05). Conclusion: VEMPs could be a diagnostic indicator for BRV patients with cochlear symptoms. The pathogenesis of BRV may be related to damage to the otolithic apparatus.

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Clinical features of BPPV and their influence on the choice of the doctor’s tactics

Cited by 7 publications

References 8 publications

A critical appraisal of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo

A critical appraisal of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo

Central Positional Syndrome Mimics Benign Paroxysmal Positional Vertigo: A Case Report

Clinical and VEMPS Characteristics of Benign Recurrent Vertigo With Cochlear Symptoms and Migraine

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