Is it important to repeat the positioning maneuver after the treatment for benign paroxysmal positional vertigo?

Oliveira, Alexandra Kolontai de Sousa; Suzuki, Fábio Akira; Boari, Letícia

doi:10.1016/j.bjorl.2014.06.002

Cited by 12 publications

(11 citation statements)

References 20 publications

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“…However, there is no consensus on recovery: authors such as Oh and Soto‐Varela consider in their studies that the manoeuvre has been successful when patient‐reported vertiginous symptoms disappear and the DHM becomes negative, without specifying whether it should be negative vertigo, nystagmus or both. Babac considers success for negative DHM also without specifying whether if negative manoeuvre is referred to symptoms or just nystagmus; Oliveira for negative nystagmus regardless of patient‐reported symptoms or positional vertigo on the DHM. Most authors, like Pérez‐Fernández, Pérez and López‐Escámez, consider recovery from an episode when no positional nystagmus or vertigo on the DHM is observed, without taking into account the persistence of symptoms in daily life.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there is not a unanimous definition of episode recovery among authors: recovery is usually defined as the disappearance of nystagmus on the control DHM, but disappearance of vertigo during DHM and changes in general status (GS) in daily life activities reported by patients at follow-up are also important results. Often, resolution criteria are usually not specified or there is no consensus between authors among CSP-PBBV literature [21][22][23][24][25][26][27][28] .…”

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confidence: 99%

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Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

Guerra-Jiménez¹,

Domènech‐Vadillo

Sande

et al. 2018

Clinical Otolaryngology

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

Guerra-Jiménez¹,

Domènech‐Vadillo

Sande

et al. 2018

Clinical Otolaryngology

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“…authors to perform a verifying positional test. 23,24 The opening to the horizontal canal is immediately adjacent to the common crus, which increases the risk of canal switch, if verifying positional test is performed earlier. It is speculated that the aggregate of high-mass otoconia are cleared out of canal mostly with lesser number of maneuvers compared with large number of low-mass otoconia dispersed throughout the canal.…”

Section: Videomentioning

confidence: 99%

A Case of Right Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo with to-and-fro Canal Switch to Right Horizontal Semicircular Canal

Vats¹

2020

Annals of Otology and Neurotology

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Background Canal switch in BPPV is a phenomenon occurring after therapeutic canalith repositioning maneuvers (CRM), when there is a reflux of the repositioned otoconial debris from utricle to semicircular canal other than the one originally affected. It may be of immediate-type occurring within minutes after CRM or a delayed-type occurring after 2-3 days. Aim The study is a case report. Case Report A 59-year-old female presented with history of severe rotational vertigo as she got up from the bed in the early morning at 5.00 a.m.. Dix-Hallpike test (DHT) on the right elicited an upbeating positional nystagmus (PN). Treatment with multiple consecutive modified right Epley maneuvers (r-MEM) in one session was undertaken. During these maneuvers she continued to have an upbeating PN during the 45-degrees right cervical rotation with the neck in 20-degrees of extension (which is equivalent to right Dix-Hallpike positioning) of the first three sequential r-MEM’s. With the neck maintained in 20-degrees of extension, during fourth consecutive r-MEM, the 45-degrees cervical rotation to right elicited apogeotropic horizontal PN. Supine roll test (SRT) was immediately undertaken. Maximal head yaw positioning to right as well as to the left elicited apogeotropic horizontal PN without torsional component lasting more than one minute, indicating reflux of otoconia from the right P-SCC to the short anterior arm of right H-SCC. She was treated with two sequences of Appiani maneuver and SRT one hour later elicited geotropic upbeating PN with vertigo, indicating second canal switch to P-SCC. It was successfully treated with two sequences of right EM fifteen minutes apart, with instructions to stay upright in between and after the maneuvers. At 24 hours, repeat DHT and SRT were negative and patient was asymptomatic. Conclusion An optimal time delay to perform a verifying positional test after therapeutic session with CRM is crucial to prevent the immediate type of reflux of relocated otoconia from the utricle into a different semicircular canal. In centers, where more than a single EM is performed in a single session of treatment, a delay of 10 to 15 minutes appears to be appropriate between successive maneuvers. A certain period of restraint in the vertical position after CRM may prevent immediate reflux, but this needs to be confirmed by the randomized control trials.

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“…BPPV was first described by Barany in the literature in 1921. [15] He attributed this lesion with otolithic organs. Dix and Hallpike in 1952 first performed provocative positional testing which was named in their honor.…”

Section: Prevalence and Incidencementioning

confidence: 99%

Prevalence of Benign Paroxysmal Positional Vertigo: Our experiences at a tertiary care hospital of India

Swain¹,

Behera

Sahu

2018

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Introduction:Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.BPPV is often overlooked by general physician and treated with anti-vertigo drugs. Objective: To evaluate the prevalence, incidence,clinical presentation of benign paroxysmal positional vertigo (BPPV). Also assessing the age,gender and site of the lesion,association with other vestibular disorders, progression, and recurrence in these patients. Materials and methods:A retrospective study of total of 172patients those attended in vertigo clinic for giddiness diagnosed as BPPV. Data analyzed from medical records since last 3 years. Out of total 685 vertigo patients in our Vertigo Clinic, 172were found to suffer from BPPV.The age of the patients ranged from 23 years to 76 years with mean of 41.4 year. Results: Out of 685 patients with vertigo,172 were diagnosed as BPPV. Among them, 102 female and 70 male patients. The posterior canal was affected in 81.97 %, the lateral in 10.46 %, the anterior in 5.23 % and multiple canals in 2.32 %.The treatment maneuver used most was Epley'smaneuver. Recurrence was observed in 10.37 % of the cases. It was idiopathic in 73.83% of cases. Conclusion: BPPV is a common peripheral vestibular disorder causing significant morbidity, psychosocial impact and medical costs. Epley's maneuver provides rapid relief of symptoms of BPPV. In addition daily Brandt-Daroff exercises decrease the chances of recurrence rate.

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Is it important to repeat the positioning maneuver after the treatment for benign paroxysmal positional vertigo?

Abstract: The study shows that doing the retest after repositioning maneuver of particles in BPPV is effectual, since it has high specificity.

Cited by 12 publications

References 20 publications

Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

A Case of Right Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo with to-and-fro Canal Switch to Right Horizontal Semicircular Canal

Prevalence of Benign Paroxysmal Positional Vertigo: Our experiences at a tertiary care hospital of India

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