Management of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial

Sacco, Regina R.; Burmeister, David B.; Rupp, V.; Greenberg, Marna Rayl

doi:10.1016/j.jemermed.2013.08.116

Cited by 20 publications

(25 citation statements)

References 13 publications

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“…135,233,[245][246][247] Some studies show a resolution of BPPV over time with medications, but these studies follow patients for the period of time during which spontaneous resolution would typically occur. 170,[248][249][250][251] In 1 double-blind controlled trial comparing diazepam, lorazepam, and placebo, all groups showed a gradual decline in symptoms with no additional relief in the drug treatment arms. 251 A small study compared particle repositioning maneuvers to a medication-alone treatment arm and found that particle repositioning maneuvers had substantially higher treatment responses (78.6%-93.3% improvement) compared with medication alone (30.8% improvement) at 2-week follow-up.…”

Section: Action Statement Profile For Statementmentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

588

776

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Objective. This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV.Purpose. The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.Action Statements. The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate...

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Section: Action Statement Profile For Statementmentioning

confidence: 99%

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

588

776

View full text Add to dashboard Cite

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“…Using the 2-hour endpoints of nausea and dizziness, there were no differences between the canalith repositioning group and the medication group. 79 One might question whether nausea and dizziness in patients sitting quietly on a gurney for several hours is the ideal endpoint for a condition that produces symptoms only with positional provocation. This is particularly true considering there were equally high patient satisfaction ratings, but 9 of the 26 sought additional care for the vertigo within 30 days.…”

Section: Benign Paroxysmal Positional Vertigo In the Emergency Departmentioning

confidence: 99%

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

Fife¹,

Brevern²

2015

Neurologic Clinics

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“…The Epley procedure, among other CRPs such as Semont, Foster, and Brandt‐Daroff maneuvers, are highly beneficial in treating BPPV . Two randomized controlled studies reported that CRP has more than a 90% success rate treating BPPV as compared to placebo control …”

Section: Introductionmentioning

confidence: 99%

A mouse model for benign paroxysmal positional vertigo with genetic predisposition for displaced otoconia

Dror

Taiber

Sela

et al. 2020

Genes Brain and Behavior

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Abnormal formation of otoconia, the biominerals of the inner ear, results in balance disorders. The inertial mass of otoconia activates the underlying mechanosensory hair cells in response to change in head position primarily during linear and rotational acceleration. Otoconia associate exclusively with the two gravity receptors, the utricle and saccule. The cristae sensory epithelium is associated with an extracellular gelatinous matrix known as cupula, equivalent to otoconia. During head rotation, the inertia of endolymphatic fluids within the semicircular canals deflects the cupula of the corresponding crista and activates the underlying mechanosensory hair cells. It is

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Management of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial

Cited by 20 publications

References 13 publications

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Benign Paroxysmal Positional Vertigo in the Acute Care Setting

A mouse model for benign paroxysmal positional vertigo with genetic predisposition for displaced otoconia

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