Intractable Benign Paroxysmal Positional Vertigo in Patients With Meniere's Disease

Gross, Eric M.; Ress, Bradford D.; Viirre, Erik; Nelson, James R.; Harris, Jeffrey P.

doi:10.1097/00005537-200004000-00022

Cited by 103 publications

(96 citation statements)

References 14 publications

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“…Almost one third of them were MD (2.8%). The incidence of BPPV associated with MD in this series was 3.2% and it is close to the previous reports [11][12][13][14][15] . Differential diagnosis of peripheral vestibular problems is primarily based on the patient's story.…”

Section: Discussionsupporting

confidence: 90%

Co-existence of Benign Paroxysmal Positional Vertigo and Meniere’s Syndrome

Yetışer¹

2017

Int Adv Otol

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OBJECTIVE:Recent studies indicate interrelation of benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD). These two entities may have different clinical characteristics. MATERIALS and METHODS:Five hundred thirty patients with BPPV evaluated between 2009-2015 were enrolled in the study. 351 patients who had no clear problem associated with BPPV (idiopathic) and 17 patients with MD were analyzed in detail. The age, sex, site of involvement, type of BPPV, symptom duration, and treatment outcome were compared. RESULTS:Meniere's disease + BPPV was more common in the female population (2/15; 7.5 v 127/224; 1.8, p<0.05). Comparative analysis of average age was not statistically significant (42.82±9.94 v. 40.29±1.65, p=0.601). There was no difference in right and left ear involvement between groups. Lateral canal involvement was more common in the BPPV + MD group (9/17; 53% v. 100/351; 28%, p<0.05). BPPV was ipsilateral to the ear with MD in 75% of patients and it was present before the diagnosis of BPPV in 82.3% of patients. Comparative analysis of cure rate between idiopathic BPPV and BPPV + MD after one session was significant (64.7% v 78%, p<0.05). CONCLUSION:Benign paroxysmal positional vertigo associated with MD presented a divergent picture. It was more frequent in females. Lateral canal involvement was higher. Patients had MD before the development of BPPV and they had prolonged symptoms, which raised a question of diagnostic delay since these two problems were in the same ear in majority of patients. Finally, relief of symptoms required more attempts of repositioning maneuvers.

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Section: Discussionsupporting

confidence: 90%

Co-existence of Benign Paroxysmal Positional Vertigo and Meniere’s Syndrome

Yetışer¹

2017

Int Adv Otol

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“…Failure in treatment or greater number of repositioning maneuvers required for the success of treatment may be owed to many different factors, including cupulolithiasis, atelectasia of vestibular membranous labyrinth and inappropriate repositioning maneuvers. The degeneration of utriculus macula or detachment of otolithic membrane would cause failure in therapeutic maneuver 22 . Aranda-Moreno, Jáuregui-Renaud 23 mentioned the fact that the association of BPPV and other labyrinthic affections may increase the number of required therapeutic maneuvers.…”

Section: Discussionmentioning

confidence: 99%

“…Aranda-Moreno, Jáuregui-Renaud 23 mentioned the fact that the association of BPPV and other labyrinthic affections may increase the number of required therapeutic maneuvers. Gross et al 22 described nine cases of patients with Meniere disease associated with BPPV that did not respond to therapeutic maneuvers. In such cases, repeated distensions of the membranous labyrinth caused by endolymphatic hypertension would cause a collapse of the labyrinth or would facilitate the adhesion of particles, which would prevent the removal from the semicircular canals.…”

Section: Discussionmentioning

confidence: 99%

Quantas manobras são necessárias para abolir o nistagmo na vertigem posicional paroxística benigna?

Dorigueto

Ganança

2005

Rev. Bras. Otorrinolaringol.

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OBJETIVO: Avaliar o número de manobras necessárias para abolir o nistagmo posicional em pacientes com Vertigem Posicional Paroxística Benigna e verificar possíveis influências do substrato fisiopatológico e/ou canal semicircular acometido. FORMA DE ESTUDO: clínico prospectivo com coorte transversal. MATERIAL E MÉTODO: Sessenta pacientes com Vertigem Posicional Paroxística Benigna foram tratados por meio das manobras de reposicionamento de estatocônios, repetidas semanalmente até a abolição do nistagmo. A Análise de Variância foi aplicada para verificar diferenças entre as variáveis dos fatores "substrato fisiopatológico" e "canal semicircular acometido". RESULTADOS: Foram necessárias de 1 a 8 manobras, em média 2,13 para abolir o nistagmo posicional. A cupulolitíase necessitou de um número maior de manobras que a ductolitíase (p=0,0002*) e não houve diferença entre os canais semicirculares (p=0,5213). Nos canais anterior e posterior, a ductolitíase precisou em média de uma a duas manobras e a cupulolitíase precisou em média de três manobras. No canal lateral, tanto a ductolitíase quanto a cupulolitíase precisaram de duas manobras, em média. CONCLUSÕES: São necessárias de uma a oito manobras semanais de reposicionamento de estatocônios, em média duas, para eliminar o nistagmo posicional na Vertigem Posicional Paroxística Benigna. A cupulolitíase necessita de maior número de manobras que a ductolitíase. O canal semicircular acometido não influencia o número de manobras terapêuticas.

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“…Vestibular neuronitis is associated with approximately 15% of the cases 6 and Ménière's disease is present between 0.5% and 31% of BPPV 9,10 . Authors such as Gross 11 , conversely, observed that approximately 5.5% of the patients with Ménière's disease presented typical BPPV of posterior semicircular canal and these cases were of difficult clinical control of positional symptomatology. Ishiyama 12 and Lempert 13 have recently described the association between migraine and cause of BPPV in 5% of the cases, as observed in most of the children in the study by Uneri 7 .…”

Section: Introductionmentioning

confidence: 99%

Restrições posturais não interferem nos resultados da manobra de reposição canalicular

Simoceli

Bittar

Greters

2005

Rev. Bras. Otorrinolaringol.

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Beni gn Paroxysmal Positional Vertigo (BPPV) is a frequentcause of dizziness and despite of the excellent results with its treatment, there is some controversy about management. Aim: To assess the efficacy of Epley Maneuver with and without post-maneuver restrictions. Study Design: Prospective randomized. Material and Method: Fifty patients presenting BPPV of the posterior semicircular canal, treated with Epley Maneuver and divided into two groups: study group -23 patients -with post-maneuver restrictions, and control group -27 patients -without post-maneuver restrictions. Results: No significant difference was found between the studied and the control group. Conclusion: Post-maneuver restrictions do not influence the efficacy of Epley Maneuver for BPPV management.

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Intractable Benign Paroxysmal Positional Vertigo in Patients With Meniere's Disease

Cited by 103 publications

References 14 publications

Co-existence of Benign Paroxysmal Positional Vertigo and Meniere’s Syndrome

Co-existence of Benign Paroxysmal Positional Vertigo and Meniere’s Syndrome

Quantas manobras são necessárias para abolir o nistagmo na vertigem posicional paroxística benigna?

Restrições posturais não interferem nos resultados da manobra de reposição canalicular

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