Benign paroxysmal positional vertigo and orthostatic hypotension

Pezzoli, M; Garzaro, Massimiliano; Pecorari, Giancarlo; Cena, Manuele; Giordano, Carlo; Albera, Roberto

doi:10.1007/s10286-009-0032-3

Cited by 18 publications

(7 citation statements)

References 28 publications

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“…The vestibular system participates in autonomic regulation adjusting cardiovascular control during body movement and change in posture 1920 . Patients with BPPV occasionally experience postural light-headedness when righting from a sitting position, despite successful repositioning procedures 21 ; it is similar to orthostatic dizziness reported by patients with orthostatic hypotension 22 .…”

Section: Discussionmentioning

confidence: 99%

Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV

Mazzucco

Mazzola

Martines

2019

Acta Otorhinolaryngol Ital

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SUMMARYAfter successful treatment for benign paroxysmal positional vertigo, many patients may complain of residual dizziness. Possible explanations may be the persistence of otolith into canal insufficient to provoke noticeable nystagmus, utricular dysfunction and undiagnosed coexisting vestibular disorder. We conducted a prospective observational case-control study, focusing on the role of risk factors in determining residual dizziness after BPPV treatment. In the present study, 148 patients were recruited and residual dizziness was documented in the 57.5% of the cohort. Among patients with residual dizziness 36 had subclinical BPPV and after retreatment, although nystagmus was not clinically evident, there was resolution of dizziness. We conclude that residual otoliths may play a role in determining post-maneuver residual dizziness that is often linked to subclinical BPPV; this conclusion is also supported by the high prevalence of BPPV recurrence in patients with residual dizziness, as confirmed by our analysis. The main cause appears to be linked with dispersed otolith in semicircular canals.

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Section: Discussionmentioning

confidence: 99%

Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV

Mazzucco

Mazzola

Martines

2019

Acta Otorhinolaryngol Ital

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“…A false otolith input appears to activate an erroneous vestibular sympathetic reflex, leading to paradoxical inactivation of the baroreflex, and resulting in syncope that mimics a vasovagal attack [ 100 ]. Patients with BPPV occasionally experience non-specific dizziness with postural lightheadedness, especially when rising from sitting, despite successful removal of detached otolith particles with appropriate canal repositioning procedures [ 101, 102 ]. This residual dizziness is similar to orthostatic dizziness reported by patients with OH [ 103 ].…”

Section: Commentsmentioning

confidence: 99%

Hemodynamic orthostatic dizziness/vertigo: Diagnostic criteria

Kim

Bisdorff

Bronstein

et al. 2019

VES

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This paper presents the diagnostic criteria for hemodynamic orthostatic dizziness/vertigo to be included in the International Classification of Vestibular Disorders (ICVD). The aim of defining diagnostic criteria of hemodynamic orthostatic dizziness/vertigo is to help clinicians to understand the terminology related to orthostatic dizziness/vertigo and to distinguish orthostatic dizziness/vertigo due to global brain hypoperfusion from that caused by other etiologies. Diagnosis of hemodynamic orthostatic dizziness/vertigo requires: A) five or more episodes of dizziness, unsteadiness or vertigo triggered by arising or present during upright position, which subsides by sitting or lying down; B) orthostatic hypotension, postural tachycardia syndrome or syncope documented on standing or during head-up tilt test; and C) not better accounted for by another disease or disorder. Probable hemodynamic orthostatic dizziness/vertigo is defined as follows: A) five or more episodes of dizziness, unsteadiness or vertigo triggered by arising or present during upright position, which subsides by sitting or lying down; B) at least one of the following accompanying symptoms: generalized weakness/tiredness, difficulty in thinking/concentrating, blurred vision, and tachycardia/palpitations; and C) not better accounted for by another disease or disorder. These diagnostic criteria have been derived by expert consensus from an extensive review of 90 years of research on hemodynamic orthostatic dizziness/vertigo, postural hypotension or tachycardia, and autonomic dizziness. Measurements

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“…Patients suffering from BPPV noted brief attacks of vertigo due to changes in head position. Fascinatingly, hypotension and sympathoneural dysfunction appears to be the underlying mechanisms of residual dizziness in patients with BPPV (9,10).…”

Section: Introductionmentioning

confidence: 99%