Subjective benign paroxysmal positional vertigo in patients with osteoporosis or migraine

González-Aguado, Rocío; Domènech‐Vadillo, Esther; Sande, María Guadalupe Álvarez-Morujo de; Guerra-Jiménez, Gloria; Domínguez-Durán, Emilio

doi:10.1016/j.bjorl.2018.10.003

Cited by 6 publications

(3 citation statements)

References 22 publications

(24 reference statements)

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“…In a prospective case-control study published in October 2018, no association was found between the use of anti-vertigo drugs (betahistine and sulpride) and the presence or absence of nystagmus. 22 Our findings, by contrast, are consistent with those of Tan et al, 23 who found higher rates of vestibular suppressant medication use in patients who tested positive for vertigo on positional testing than in those who tested positive for both vertigo and nystagmus. When the patients were retested following withdrawal of medication (mostly benzodiazepines and antihistamines), 50% showed nystagmus (i.e., they had typical BPPV).…”

Section: Discussionsupporting

confidence: 91%

Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo

et al. 2021

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Patients who experience both vertigo and nystagmus in the Dix-Hallpike test (DHT) are diagnosed with objective benign paroxysmal positional vertigo (BPPV). This test provokes only vertigo in between 11% and 48% of patients, who are diagnosed with subjective BPPV. Detection of nystagmus has important diagnostic and prognostic implications. To compare the characteristics of patients diagnosed with objective and subjective BPPV in primary care. Cross-sectional descriptive study. Two urban primary care centers. Adults (≥18 years) diagnosed with objective or subjective BPPV between November 2012 and January 2015. DHT results (vertigo or vertigo plus nystagmus; dependent variable: nistagmus as response to DHT), age, sex, time since onset, previous vertigo episodes, self-reported vertigo severity (Likert scale, 0–10), comorbidities (recent viral infection, traumatic brain injury, headache, anxiety/depression, hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, altered thyroid function, osteoporosis, cervical spondylosis, neck pain). In total, 134 patients (76.1% women) with a mean age of 52 years were included; 59.71% had subjective BPPV. Objective BPPV was significantly associated with hypertension, antihypertensive therapy, and cervical spondylosis in the bivariate analysis and with cervical spondylosis (OR = 3.94, p = 0.021) and antihypertensive therapy (OR 3.02, p = 0.028) in the multivariate analysis. Patients with subjective BPPV were more likely to be taking benzodiazepines [OR 0.24, p = 0.023]. The prevalence of subjective BPPV was higher than expected. Cervical spondylosis and hypertensive therapy were associated with objective BPPV, while benzodiazepines were associated with subjective BPPV.

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Section: Discussionsupporting

confidence: 91%

Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo

et al. 2021

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“…reported an incidence of S-BPPV of 24.71%, 34.28%, and 25%, respectively, in their studies. [ 5 14 19 ] The incidence of S-BPPV in our study was 21.24%, which is comparable to other studies. Both the varieties of BPPV were twice more common in females similarly to other studies.…”

Section: Discussionsupporting

confidence: 88%

“…[ 11 ] However, some of the patients with typical vertiginous symptoms but no nystagmus on DHT or SRT are classified as subjective BPPV (S-BPPV), while those with nystagmus are classified as objective BPPV (O-BPPV). [ 12 13 14 ] The treating physician unaware of S-BPPV entity may subject the patients for extensive electrophysiological and neuroimaging diagnostic workup for diagnosis of vertigo. [ 13 15 ]…”

Section: Introductionmentioning

confidence: 99%

Negative impact of vestibular suppressant drugs on provocative positional tests of BPPV: A study from the Western Part of India

Gurumukhani¹,

Patel²,

Shah³

et al. 2021

Ann Indian Acad Neurol

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Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30–4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2–197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients. Study Design: Prospective case-control observational study.

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Short-Term Effect of Epley Maneuver as Treatment for Subjective Benign Paroxysmal Positional Vertigo

Celis‐Aguilar

Medina-Cabrera

Torrontegui-Zazueta

et al. 2021

Indian J Otolaryngol Head Neck Surg

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Subjective benign paroxysmal positional vertigo in patients with osteoporosis or migraine

Cited by 6 publications

References 22 publications

Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo

Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo

Negative impact of vestibular suppressant drugs on provocative positional tests of BPPV: A study from the Western Part of India

Short-Term Effect of Epley Maneuver as Treatment for Subjective Benign Paroxysmal Positional Vertigo

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