Relationship between orthostatic hypotension and recurrence of benign paroxysmal positional vertigo

Kim, Moon Jung; Rhim, Gu Il

doi:10.1038/s41598-022-15029-5

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…Considering that most of these orthostatic dizziness patients were diagnosed by changes in blood pressure or heart rate in the tilt table test, physicians should also pay attention while taking their history to whether pediatric patients complain of dizziness while changing to the upright position or lying/bending down. The relationship between orthostatic dizziness and BPPV is unclear but recent studies have shown the correlation between BPPV-induced otolith organ hypofunction and transient orthostatic hypotension [23,24].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Benign Paroxysmal Positional Vertigo: Degree of Nystagmus and Concurrent Dizziness Differs from Adult BPPV

An,

Kim,

Park

et al. 2024

JCM

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Background: Benign paroxysmal positional vertigo (BPPV) is characterized by brief, intense episodes of vertigo triggered by abrupt changes in head position. It is generally accepted as being most common in adults, while it is regarded as rare in children. It is necessary to compare the disease between pediatric and adult patients for a better understanding of the disease’s characteristics and its natural history. This study aimed to identify the clinical characteristics of BPPV in children and compare them with those of adult BPPV patients. Methods: All children ≤ 18 years old who were diagnosed with BPPV were selected by searching the electronic database of our hospital. Clinical features were identified by medical record review. For adult patients, we collected data from patients > 19 years of age. Results: A total of 30 pediatric (13.65 ± 4.15 years old) and 264 adult patients (60.86 ± 13.74 years old) were included in the study. Among pediatric patients, the lateral canals were involved in 80% and the posterior canals in 16.67%. In adult patients, the lateral and posterior canals were involved similarly (p = 0.007). The degree of nystagmus in pediatric patients was 6.82 ± 12.09, while in adults it was 15.58 ± 20.90 (p < 0.001). The concurrent dizziness disorder was higher in the pediatric group and recurrence was higher in the adult group. In the regression analysis, it was found that adult patients had a stronger nystagmus with a value of 6.206 deg/sec, and the risk of concurrent dizziness disorder was found to be 5.413 times higher in the pediatric group (p < 0.05). Conclusions: BPPV occurs in pediatric patients with lower prevalence, but it cannot be overlooked. In the pediatric group, a relatively high proportion of patients demonstrated lateral canal involvement, weaker nystagmus, and additional dizziness disorder.

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Section: Discussionmentioning

confidence: 99%

Pediatric Benign Paroxysmal Positional Vertigo: Degree of Nystagmus and Concurrent Dizziness Differs from Adult BPPV

An,

Kim,

Park

et al. 2024

JCM

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“…When the vestibular evoked myogenic potential (VEMP) response was absent, the diastolic blood pressure dropped significantly at 1 min of active standing [ 9 ]. Furthermore, orthostatic hypotension (OH) accompanying benign paroxysmal positional vertigo (BPPV) affects the recurrence of BPPV [ 10 ], and utricular dysfunction is associated with OH [ 11 ]. The current study hypothesized that if otolith organ acts complementarily with the autonomic nervous system to maintain blood pressure, blood pressure variability may affect otolith organ.…”

Section: Introductionmentioning

confidence: 99%

Effect of the early diastolic blood pressure response to the head-up tilt test on the recurrence of benign paroxysmal positional vertigo

Rhim,

Kim

2024

PLoS ONE

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Background Otolith organ acts complementarily with the autonomic nervous system to maintain blood pressure. However, the effect of blood pressure variability in the autonomic nervous system on otolith organ has not yet been determined. This study aimed to verify the hypothesis that blood pressure variability in the autonomic nervous system affects the recurrence of benign paroxysmal positional vertigo (BPPV), which is the most common disease of the vestibular organs, by using the head-up tilt test (HUTT). Methods This study included 432 patients diagnosed with idiopathic BPPV. The follow-up period for all patients was 12 months. Age, sex, hypertension, diabetes and recurrence were analyzed. The HUTT parameters were divided into a group of patients whose average diastolic blood pressure increased in the upright position compared to supine position during the HUTT (DBP1) and a group of patients whose average diastolic blood pressure decreased in the upright position compared to supine position during the HUTT (DBP2). Model selection, general loglinear analysis, and logit loglinear analysis were performed using a hierarchically progressing loglinear analysis. Results In summary, the group with increased average diastolic blood pressure (DBP1) showed a higher tendency for BPPV recurrence compared to the group with decreased diastolic blood pressure (DBP2) in the upright position during the HUTT, although the difference was not statistically significant (p = 0.080). However, in males, the DBP1 group demonstrated a significantly higher recurrence rate of BPPV than the DBP2 group during the HUTT (95% CI, -20.021 to -16.200; p < 0.001). Conclusions It is presumed that poor autonomic nervous system response through vestibulosympathetic reflex maintains elevated diastolic blood pressure in the upright position during the HUTT. This variability is assumed to affect the recurrence of BPPV.

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Volume ratio and distribution rate in patients with orthostatic vertigo/dizziness using MR imaging: a comparison with vertiginous diseases

Inui¹,

Sakamoto²,

Ueda

et al. 2023

Acta Oto-Laryngologica

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Relationship between orthostatic hypotension and recurrence of benign paroxysmal positional vertigo

Cited by 6 publications

References 20 publications

Pediatric Benign Paroxysmal Positional Vertigo: Degree of Nystagmus and Concurrent Dizziness Differs from Adult BPPV

Pediatric Benign Paroxysmal Positional Vertigo: Degree of Nystagmus and Concurrent Dizziness Differs from Adult BPPV

Effect of the early diastolic blood pressure response to the head-up tilt test on the recurrence of benign paroxysmal positional vertigo

Volume ratio and distribution rate in patients with orthostatic vertigo/dizziness using MR imaging: a comparison with vertiginous diseases

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