Subjective visual vertical before and after treatment of a BPPV episode

Faralli, Mario; Manzari, Leonardo; Panichi, Roberto; Botti, Fabio Massimo; Ricci, Giampietro; Longari, Fabrizio; Pettorossi, Vito Enrico

doi:10.1016/j.anl.2010.10.005

Cited by 28 publications

(39 citation statements)

References 10 publications

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“…First, after successful repositioning maneuvers, 20–40% of patients with BPPV complain of transient postural imbalance and in posturographic studies increased body sway was found [17]. Second, a deviation of subjective visual vertical (SVV), which normalized within weeks to months, was described after liberatory maneuvers [18]. This finding is in agreement with our finding that 1 month after therapy the oVEMP amplitudes of responders were not statistically significant any more in comparison to those before therapy.…”

Section: Discussionmentioning

confidence: 99%

Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo

Bremova-Ertl

Bayer

Agrawal

et al. 2013

Acta Oto-Laryngologica

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Conclusions This study showed a transient increase of ocular vestibular evoked myogenic potential (oVEMP) amplitudes in the affected ear after successful liberatory maneuvers and no changes in cervical VEMP (cVEMP) amplitudes. These findings support the hypothesis that successful liberatory maneuvers can lead to a repositioning of otoconia to the utricle. Objectives To evaluate whether oVEMP amplitudes increase after successful liberatory maneuvers in patients with posterior semicircular canal benign paroxysmal positioning vertigo (pc-BPPV), while cVEMP amplitudes do not change. These findings may indicate a successful repositioning of dislodged otoconia to the utricular macula, but not to the saccular macula. Methods Thirty patients with unilateral pc-BPPV were prospectively examined with bone-conducted oVEMP and air-conducted cVEMP at four time points: before, after, 1 week after, and 1 month after the liberatory maneuvers (Sémont maneuvers). Results At the 1-week follow-up, 20 of 30 patients were asymptomatic (responders); BPPV could still be induced in the other 10 (non-responders). In responders the mean n10 amplitude on the affected side increased from 12 ± 6.5 μV at baseline (before the treatment) to 15.9 ± 7.1 μV at 1 week after treatment; this increase was significantly (p = 0.001) higher in responders than in non-responders. cVEMP did not differ significantly.

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Section: Discussionmentioning

confidence: 99%

Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo

Bremova-Ertl

Bayer

Agrawal

et al. 2013

Acta Oto-Laryngologica

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“…That is, the degree of SVV tilting was significantly higher in the active BPPV group than in the normal group when untreated but showed an inversion after repositioning maneuver [9]. From this viewpoint, we adopted the SVV test to evaluate the utricular function of the patients 2 weeks after performing the repositioning maneuver.…”

Section: Subjective Visual Verticalmentioning

confidence: 99%

Anxiolytics reduce residual dizziness after successful canalith repositioning maneuvers in benign paroxysmal positional vertigo

Jung

Koo

Kim

et al. 2011

Acta Oto-Laryngologica

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“…Gall et al found differences between normals and BPPV patients pre-treatment but von Brevern et al (9) did not. More recently Faralli et al reported slight but statistically significant differences between normals and pre-treatment BPPV patients (10). No other studies have addressed BPPV and SVV.…”

Section: Introductionmentioning

confidence: 98%

“…By contrast Gall et al (8) had subjects state the correct orientation of a line that the examiner moved, so the subject’s somatosensory input was not involved. Three other groups used paradigms that involved minimal limb movement to push buttons or to operative a remote control device, but not to rotate a device (5, 9, 10). …”

Section: Introductionmentioning

confidence: 99%

Subjective visual vertical in vestibular disorders measured with the bucket test

Cohen

Sangi‐Haghpeykar

2012

Acta Otolaryngol

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Conclusion The “bucket test” may indicate that patients with known vestibular disorders have spatial orientation deficits but due to the low ROC values it is not useful for screening people for vestibular impairments. Objectives 1) to verify that patients with unilateral peripheral vestibular weakness (UW) differ from normals on the bucket test, 2) to determine if patients with unilateral benign paroxysmal positional vertigo (BPPV) differ from normals, 3) to determine the sensitivity and specificity of the test. Method Patients with UW (25) and BPPV (25) were compared to normals (50). Subjects looked into a clean bucket with a vertical line on the bottom, which rested on a table. It was rotated, clockwise or counterclockwise, for three trials per direction until the subject indicated the line was vertical. The dependent measure was the mean absolute value of the deviations from the true vertical. Results Some, but not all, patients’ responses differed from normals but responses also differed by age and sex. ROC values were all weak, i.e., < 0.8. No good cut-points differentiated controls from patients. Thus, although the bucket test is useful for describing spatial deficits in patients this test is not useful for screening people for possible vestibular impairments.

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Subjective visual vertical before and after treatment of a BPPV episode

Cited by 28 publications

References 10 publications

Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo

Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo

Anxiolytics reduce residual dizziness after successful canalith repositioning maneuvers in benign paroxysmal positional vertigo

Subjective visual vertical in vestibular disorders measured with the bucket test

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