Curing Benign Paroxysmal Positional Vertigo (BPPV) Through Telehealth: A Case Series

Bashir, Khalid; Yousuf, Abdulla; Rauf, Lubna; Dewji, Mohamed; Elmoheen, Amr

doi:10.7759/cureus.16363

Cureus

2021

DOI: 10.7759/cureus.16363

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Curing Benign Paroxysmal Positional Vertigo (BPPV) Through Telehealth: A Case Series

Khalid Bashir¹,

Abdulla Yousuf²,

Lubna Rauf³

et al.

Abstract: Benign paroxysmal positional vertigo (BPPV) is a common medical condition in which the patient feels a spinning sensation when making certain head movements. There is evidence to support those free-floating calcium crystals in the semi-circular canals (the inner ear) may be the cause. BPPV can be a disabling condition. It can be easily diagnosed after taking a careful history and performing bedside examinations. BPPV can be treated successfully through a specific set of physical maneuvers leading to the remova… Show more

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“…16,17 Due to the limited access to medical care provider during the COVID-19 pandemic, telemedicine for diagnosis and treatment of BPPV was proposed as a good alternative. [18][19][20] To our knowledge, this study is the first to examine the impact of COVID-19 on the incidence of BPPV subtypes by hospital visit (OPD vs ER), and the mean time interval between vertigo onset and primary evaluation. Our data demonstrated that the total number of BPPV patients who were diagnosed in the ER and OPD decreased by 15.9% (517 to 435) during the…”

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Change in Diagnosis of Benign Paroxysmal Positional Vertigo During COVID-19 Pandemic

Lee¹,

Shin²,

Jung³

et al. 2022

IJGM

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The present study investigated the impact of coronavirus disease 2019 (COVID-19) pandemic on benign paroxysmal positional vertigo (BPPV). Patients and Methods:The medical records of BPPV patients who were evaluated in the outpatient department (OPD) and emergency room (ER) during (435 patients) and before (517 patients) the COVID-19 pandemic were retrospectively reviewed. Dix-Hallpike and supine head-roll tests were used to classify the subtype of BPPV as posterior semicircular canal (PSCC), geotropic lateral semicircular canal (geotropic LSCC), or apogeotropic lateral semicircular canal (apogeotropic LSCC) BPPV. Results: More patients with PSCC BPPV were diagnosed at the OPD compared with those who were diagnosed at the ER both before and during the COVID-19 pandemic; however, more patients with LSCC BPPV were diagnosed at the ER compared with those who were diagnosed at the OPD during the same periods. The mean time interval between vertigo onset and initial evaluation was remarkably longer during the pandemic in patients with PSCC BPPV. Conclusion:This study demonstrated that the incidences of BPPV subtypes according to hospital visit type were not significantly different before and during the COVID-19 pandemic. Because hospital visits were delayed in patients with PSCC BPPV during the COVID-19 pandemic, telemedicine or e-health could be suitable alternatives to face-to-face medical care for these patients.

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mentioning

confidence: 99%

Change in Diagnosis of Benign Paroxysmal Positional Vertigo During COVID-19 Pandemic

Lee¹,

Shin²,

Jung³

et al. 2022

IJGM

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show abstract

“…Hence, specific diagnostic positional maneuvers can be used to induce vertigo and nystagmus in order to identify the affected semicircular canal by analyzing the characteristics of the nystagmus. The otolith can be moved to the utricle by correct repositioning (9).…”

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confidence: 99%

Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

Yang²

2023

Front. Neurol.

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BackgroundThe preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.ObjectivesTo investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.Materials and methodsBased on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using 3D Slicer software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.ConclusionsThe 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.

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Curing Benign Paroxysmal Positional Vertigo (BPPV) Through Telehealth: A Case Series

Cited by 2 publications

References 19 publications

Change in Diagnosis of Benign Paroxysmal Positional Vertigo During COVID-19 Pandemic

Change in Diagnosis of Benign Paroxysmal Positional Vertigo During COVID-19 Pandemic

Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

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