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Review
- Management of Benign Paroxysmal Positional Vertigo
- Chan Il Song, Hong Ju Park
- Res Vestib Sci. 2013;12(4):111-120.
- 2,194 View
- 123 Download
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Abstract
PDF - Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by head positional changes. BPPV is one of the most common causes of recurrent vertigo. BPPV results from abnormal stimulation of the cupula within any of the three semicircular canals by free-floating otoliths (canalithiasis) or otoliths adhered to the cupula (cupulolithiasis). Spontaneous recovery occurs frequently even with conservative treatment. However, canalith repositioning maneuvers are believed to be the best way to treat BPPV by moving the canaliths from the semicircular canal to the vestibule. Various treatment methods of posterior, superior, and lateral canal BPPV are discussed in this review.
Original Articles
- Clinical Significance of Vestibular Evoked Myogenic Potentials in Patients With Benign Paroxysmal Positional Vertigo
- Won Sun Yang, Dae Bo Shim, Won Sang Lee
- J Korean Bal Soc. 2008;7(1):38-42.
- 1,997 View
- 12 Download
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Abstract
PDF
- Objectives: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV. Subjects and Methods: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment. Results: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the “no response” group, the number of times was considerably greater than those in the “response” group. Conclusions: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as “no response” in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV.
- Therapeutic Efficacy and Prognostic Factors of Canalith Repositioning Maneuver in the Patients with Benign Paroxysmal Positional Vertigo
- Shi Nae Park, Kyoung Ho Park, Ji Hong Kim, Jong Hoon Kim, Bong Jin Choi, Ji Hyeon Shin, Min Ah Han, Sang Won Yeo
- J Korean Bal Soc. 2007;6(1):9-15.
- 1,845 View
- 16 Download
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Abstract
PDF
- Background and Objectives: The purpose of this study were to evaluate the therapeutic efficacy of canalith repositioning maneuver (CRP) according to accompanying mastoid percussion and to investigate the prognostic factors that may affect successful repositioning maneuver and the recurrence of benign paroxysmal positional vertigo. Materials and Method: A total of 70 patients with canalith type BPPV visiting the dizziness clinic of Kangnam St. Mary's Hospital were included in this study. Variables identified for statistical analysis were patient's age, sex,maneuver method, number of involved canal, number of CRP and dizziness handicap inventory. Result: Overall success rate of CRP was 90%. The mean number of maneuver was 1.6 and the recurrence rate was 25.7% during the follow up period. Success rate of CRP (94.9%) was higher than maneuver without mastoid percussion (83.9%) though it was not statistically significant. Successful CRP group showed the significant less number of maneuvers at initial treatment session and less number of involved canal than failed CRP group at the time of one week-follow up visit. Patients with recurrence of BPPV had the more number of CRP during the period of previous BPPV. Conclusion: Therapeutic efficacy of CRP with mastoid percussion was higher than CRP without mastoid percussion though it was not statistically significant. Suggesting prognostic factors for effective CRP and recurrence were number of CRP and number of involved canal.
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