Magnetic resonance imaging predicts chronic dizziness after benign paroxysmal positional vertigo

Woon, Wang; Song, Kudamo; Yu, In Kyu; Choi, Myoung Su; Chang, Dong Sik; Cho, Chin-Saeng; Lee, Ho Yun

doi:10.1016/j.amjoto.2017.04.001

Cited by 5 publications

(20 citation statements)

References 35 publications

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“…Generally, a positional nystagmus test is negative, without nausea and vomiting [16,41,42]. The duration of RD symptoms ranges from a few days to weeks, and even several months have been previously reported [12,16,[37][38][39]42]. The mechanism may be due to an additional vestibular dysfunction that coexists with BPPV and causes less-specific dizziness or incomplete central adaptation, which needs a longer time after repositioning [43][44][45].…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…Among them, WMH was the most common CSVD, which is consistent with the findings of Cha and others. Through investigation of the brain MRI of BPPV patients in the emergency department, Cha et al found that about 70% of patients had WMH 12 . There were many factors causing WMH, among which hemodynamic changes, which are recognized by most researchers, leads to insufficient perfusion of deep brain tissue, decrease of blood flow, and finally ischemia and demyelinating changes in an area dominated by arterioles 21 , 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have indicated the recurrence of BPPV is related to gender, CRP times, previous BPPV, and is involved side and duration of disease 7 , 14 , 33 . However, some studies have the opposite view 12 , 27 , 31 . In this study, we did not find a correlation between these above factors and recurrence of BPPV.…”

Section: Discussionmentioning

confidence: 99%

“…However, the pathogenesis of acute vertigo can sometimes be very complicated, especially in middle-aged and elderly patients with more basic diseases and a complicated past medical history. Therefore, sometimes we may need an MRI to check whether such patients have other brain diseases 11 , 12 . In clinical practice, we find that many BPPV patients have lesions of cerebral small vessels, including white matter lesions.…”

Section: Introductionmentioning

confidence: 99%

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The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo

Shi¹,

Jiang²,

Feng³

et al. 2022

Int. J. Med. Sci.

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Background: Although vascular risk factors have been found to be closely related to the development of benign paroxysmal positional vertigo (BPPV), the relationship between BPPV and cerebral small vessels diseases (CSVDs) has rarely been discussed in literature. This study set out to investigate the efficacy of repositioning therapy and prognosis among BPPV patients with CSVDs. Methods: We enrolled 553 BPPV patients who had undergone brain MRI, and categorized them into two groups based on the presence or absence of CSVDs. After controlling for other confounders using a propensity score matching (PSM) approach, we compared the incidence of recurrence and residual dizziness (RD). Then, we analyzed the recurrence rate and RD incidence in 176 BPPV patients with CSVDs, and assessed potential risk factors. Results: White matter hyperintensity (WMH, 72.2%) and lacunar infarction (LI, 65.9%) were the two CSVDs that were present in the highest proportion among the BPPV patients. The incidence of RD in patients with CSVDs was significantly higher compared to subjects without CSVDs. Patients with RD (n=100, 56.8%) were older, had more severe WMH, and had a higher incidence of brain atrophy; age and higher Fazekas score were independent risk factors. Among the recurrent patients (n=61, 34.7%), the ages were older, the Fazekas score of WMH was higher, and number of LIs was increased; age was the sole independent risk factor. Conclusion: BPPV patients with a combination of CSVD comorbidities, especially elderly patients with WMHs, are more likely to develop RD, which needs to be paid more attention.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo

Shi¹,

Jiang²,

Feng³

et al. 2022

Int. J. Med. Sci.

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ACR Appropriateness Criteria® Dizziness and Ataxia: 2023 Update

Wang,

Thompson,

Shih

et al. 2024

Journal of the American College of Radiology

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Initial Degree of Spontaneous Nystagmus Affects the Length of Hospitalization of Patients With Vestibular Neuritis

Kim

Lee

et al. 2020

Otology &Amp; Neurotology

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Objective: To assess factors predicting vestibular neuritis (VN) prognosis at an early stage. Study Design: Retrospective chart review. Setting: University hospital. Patients: Sixty-five patients with VN, between 2014 and 2018. Interventions: Bithermal caloric test, rotatory chair test, subjective visual horizontal and vertical, cervical visual myogenic evoked potential test, and visual head impulse test (vHIT). Main Outcome Measures: Hospitalization duration. Results: The mean hospitalization duration was 4.6 ± 1.4 days. Mean caloric weakness was 65.5 ± 20.6%. For the vHIT, gain in both anterior and horizontal semicircular canal (SCC) was statistically significantly different between the lesion and intact sides (p < 0.001). Backward conditional regression analysis revealed that a higher degree of spontaneous nystagmus (SN) (EXP[B] = 1.104, 95% confidence interval [CI] = 1.012–1.204, p = 0.026), and a lower caloric paresis (CP) value (EXP(B) = 1.033, 95% CI = 1.000–1.075, p = 0.047) were associated with 5 days or more of hospitalization. The cut-off value of SN was 12.05 degrees/s for increased hospital stay. Four weeks after discharge from hospital, five patients (8.9%) had persistent SN, and 19 (33.9%) and 28 (50.0%) had a positive HIT and nystagmus during head-shaking, respectively. Patients with persistent nystagmus at 1 month had more severe initial SN (p < 0.05). Conclusion: Only the degree of SN at the initial evaluation affected both the hospitalization period and the bed-side examination results at 1 month after discharge in patients with VN.

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Magnetic resonance imaging predicts chronic dizziness after benign paroxysmal positional vertigo

Cited by 5 publications

References 35 publications

The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo

The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo

ACR Appropriateness Criteria® Dizziness and Ataxia: 2023 Update

Initial Degree of Spontaneous Nystagmus Affects the Length of Hospitalization of Patients With Vestibular Neuritis

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