Recurrence of Benign Paroxysmal Positional Vertigo

Pérez, Paz; Franco, Virginia; Cuesta, Paz; Aldama, Patricia Chico; Alvarez, Manuel; Méndez, Juan Carlos

doi:10.1097/mao.0b013e3182487f78

Cited by 112 publications

(90 citation statements)

References 15 publications

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“…The canalith repositioning procedure (CRP) provides successful treatment for most BPPV patients, but some patients require repetitive CRPs. In the literature, BPPV recurrence generally varies from 20% to 30%, although rates as high as 50% have been reported [3,22,28]. It is therefore important to figure out predisposing factors to help prevent the occurrence and recurrence of BPPV.…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Yang

Kim

Lee

et al. 2018

VES

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Abstract. The aim of this study was to evaluate the relationship between bone mineral density (BMD) and 25-hydroxyvitamin D with the occurrence and recurrence of BPPV. The records of 130 idiopathic BPPV patients (55 ± 12 years old, 30 men and 100 women) and 130 age-and sex-matched controls who underwent bone mineral densitometry between April 2012 and September 2015 were reviewed retrospectively. We compared the BMD and serum 25-hydroxyvitamin D between the patients and controls, and also compared the BMD between recurrent and non-recurrent BPPV groups. Among the female subjects, the BPPV group showed a significantly decreased BMD compared to the controls (p < 0.05). The men in the control group had significantly higher 25-hydroxyvitamin D levels than the men with BPPV (p < 0.05). Sixty-three patients (48%) reported recurrent attacks of BPPV. The women with recurrent BPPV were significantly older and showed a significantly lower BMD than non-recurrent women (p < 0.001). However, multiple regression analysis revealed that age alone was significantly associated with the recurrence of BPPV in women. BMD in women and serum 25-hydroxyvitamin D levels in men are associated with the occurrence of BPPV. Only age is an independent predictor of recurrence, though a low BMD and age correlate with the recurrence of BPPV.

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Section: Introductionmentioning

confidence: 99%

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Yang

Kim

Lee

et al. 2018

VES

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“…To this extent, it has been shown that the other variety of intractable BPPV, i.e., recurrent BPPV, can affect any of the three canals in both the labyrinths. This suggests that some patients suffering from BPPV do not have a particular problem with one of their ears, but they have a pathological condition involving their vestibular organs [19] . Besides, BPPV affecting several canals, either bilaterally or on the same side, is not rare and it has been reported in percentages ranking from 4 to 21% [2][3][4][5] .…”

Section: Discussionmentioning

confidence: 99%

“…It has been stated that BPPV patients requiring a large number of maneuvers have a particular tendency to relapse [19] . This may be linked to the concept of an underlying labyrinthine disease and the ionic factors mentioned above.…”

Section: Discussionmentioning

confidence: 99%

“…It could be claimed that repeated maneuvers, rather than ITMP administration, have led to the resolution of BPPV, provided that 6 or more maneuvers were unable to resolve the BPPV after at least 3 months; however, after IT steroid administration, only 1 or 2 maneuvers were effective in eliminating BPPV signs and symptoms in 7 out of the 9 patients. It would be reasonable to attribute this success to the use of IT steroids.It has been stated that BPPV patients requiring a large number of maneuvers have a particular tendency to relapse [19] . This may be linked to the concept of an underlying labyrinthine disease and the ionic factors mentioned above.…”

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confidence: 99%

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A Pilot Study Using Intratympanic Methylprednisolone for Treatment of Persistent Posterior Canal Benign Paroxysmal Positional Vertigo

Pérez¹,

Franco²,

Oliva³

et al. 2016

Int Adv Otol

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OBJECTIVE:To assess the effect of intratympanic methylprednisolone (ITMP) in posterior canal benign paroxysmal positional vertigo (BPPV) that fails treatment involving repositioning maneuver in a case series. MATERIALS and METHODS:Nine patients with persistent posterior canal BPPV after 6 or more repositioning maneuvers were treated by ITMP (two weekly doses of 0.3-0.4 mL at 40 mg/mL) before repeating the repositioning procedures. RESULTS:Following ITMP treatment, 7 out of 9 patients were relieved of their symptoms and did not exhibit positional nystagmus after 1 or 2 repositioning maneuvers. The number of positional maneuvers performed before and after ITMP treatment in these 7 patients showed a statistically significant (p=0.016) reduction in the amount of repositioning treatments required. None of the 7 respondent patients showed any relapses during the follow-up period (follow-up range: 11-95 months). CONCLUSION:Administering ITMP before resuming repositioning procedures can be a useful treatment for persistent BPPV of the posterior canal. Intratympanic (IT) steroids are often used to treat inner ear disorders such as sudden idiopathic sensorineural hearing loss, autoimmune hearing loss, and Ménière's disease [14] . Corticosteroids exert their effects in the inner ear after interacting with intracellular glucocorticoid receptors by producing metabolic and anti-inflammatory effects. It is also known that glucocorticoid receptors are widespread throughout the inner ear, including semicircular canal duct epithelial cells, where they facilitate cation absorption via sodium channels [15][16][17] . KEYWORDS:Thus, considering the possibility of an inflammatory process of the labyrinth or an imbalance of Na + and Ca 2+ in the endolymph could be related with the intractability of BPPV, we have carried out a pilot study to assess the effect of IT methylprednisolone (ITMP) in persistent posterior canal BPPV. MATERIALS and METHODSThis prospective study included patients from 3 different hospitals. From January 2006 to March 2014, we diagnosed 187 patients affected from unilateral posterior canal BPPV. None of them had any symptoms or signs of central nervous system (CNS) disease. A complete otoneurological examination, including otoscopy, audiometry, head thrust test, spontaneous nystagmus recording, gaze-evoked nystagmus test, cover test, and Romberg and Fukuda tests, were performed in all the cases.The diagnosis of posterior canal BPPV was made by Dix-Hallpike test, showing a mixed vertical and torsional nystagmus beating toward the undermost ear, with appropriate latency and duration, and the direction of the nystagmus reversed on resuming the upright position. In every patient, the roll test and head hyperextension test were also performed in order to rule out lateral or superior canal BPPV.Patients with BPPV were treated by Epley or Semont maneuvers. We carried out only one of those maneuvers in every session. Each session, weekly programmed, began with a Dix-Hallpike test; if it was positive for the same posterior...

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“…The unusual cases of multi dehiscent bony labyrinth has been described also [15,16]. Recurrent BPPV has been seen in various inner ear disorders but hasn't been described in patients with SCD syndrome yet, except the unusual case of a patient who developed posterior canal BPPV after canal plugging [16,17].…”

Section: Global Journal Of Otolaryngology Conclusionmentioning

confidence: 99%

Posterior Semicircular Canal Dehiscence Presenting with Recurrent Positional Vertigo

Pavlović¹

2016

GJO

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Vestibular symptoms to sound should arise suspicion for semicircular canal dehiscence (SCD) syndrome, especially when Tullio phenomenon or Hennebert's sign are present. But diverse clinical presentation makes this diagnosis not straightforward. Repeating episodes of positional vertigo in a patient with posterior semicircular canal dehiscence is herein presented case. Inconsistent history of patients with SCD makes this diagnosis challenging. BPPV has been described in various inner ear disorders but not yet in the SCD syndrome.

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Recurrence of Benign Paroxysmal Positional Vertigo

Cited by 112 publications

References 15 publications

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo

A Pilot Study Using Intratympanic Methylprednisolone for Treatment of Persistent Posterior Canal Benign Paroxysmal Positional Vertigo

Posterior Semicircular Canal Dehiscence Presenting with Recurrent Positional Vertigo

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