Monitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo

Molina, Maria I.; Lopez-Escamez, José A.; Zapata, Cristóbal; Vergara, Laura

doi:10.1097/mao.0b013e318067e322

Cited by 17 publications

(12 citation statements)

References 11 publications

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“…Vestibular hypofunction was reported by other authors in BPPV patients [24][25][26][27] . The Balance Rehabilitation Unit (BRU TM ) posturography showed that the stability limit area values were similar to those in the control group, indicating that our patients with BPPV had stability to move their body mass center and keep balance without changing the support basis.…”

Section: Discussionmentioning

confidence: 54%

Posturografia do Balance Rehabilitation Unit (BRU TM) na vertigem posicional paroxística benigna

Monteiro¹,

Ganança²,

Ganança³

et al. 2012

Braz. j. otorhinolaryngol.

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Post urography has been used in the evaluation of patients with vestibular disorders. Aim:To evaluate balance control with the Balance Rehabilitation Unit (BRU TM ) posturography in patients with Benign Paroxysmal Positional Vertigo. Study design: Prospective case-control. Materials and Methods:A cross-sectional controlled study was carried out in 45 patients with BPPV, and a homogeneous control group consisting of 45 healthy individuals. Patients were submitted to a balance function evaluation by means of the Balance Rehabilitation Unit (BRU TM ) posturography. Results:The mean values of the ellipse area and the sway velocity in a firm surface and saccadic stimulation (p = 0.060). Conclusion:The Balance Rehabilitation Unit (BRU TM ) posturography enables to identify postural control abnormalities in patients with BPPV. Braz J Otorhinolaryngol. 2012;78(3):98-104. ORIGINAL ARTICLE BJORL

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Section: Discussionmentioning

confidence: 54%

Posturografia do Balance Rehabilitation Unit (BRU TM) na vertigem posicional paroxística benigna

Monteiro¹,

Ganança²,

Ganança³

et al. 2012

Braz. j. otorhinolaryngol.

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“…Babac considers success for negative DHM also without specifying whether if negative manoeuvre is referred to symptoms or just nystagmus; Oliveira for negative nystagmus regardless of patient‐reported symptoms or positional vertigo on the DHM. Most authors, like Pérez‐Fernández, Pérez and López‐Escámez, consider recovery from an episode when no positional nystagmus or vertigo on the DHM is observed, without taking into account the persistence of symptoms in daily life. In other studies, resolution criteria is not specifically defined, assuming that negativization of nystagmus is used.…”

Section: Discussionmentioning

confidence: 83%

“…Therefore, there is not a unanimous definition of episode recovery among authors: recovery is usually defined as the disappearance of nystagmus on the control DHM, but disappearance of vertigo during DHM and changes in general status (GS) in daily life activities reported by patients at follow-up are also important results. Often, resolution criteria are usually not specified or there is no consensus between authors among CSP-PBBV literature [21][22][23][24][25][26][27][28] .…”

mentioning

confidence: 99%

Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

Guerra-Jiménez¹,

Domènech‐Vadillo

Sande

et al. 2018

Clinical Otolaryngology

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“…Strupp et al [7] have pointed out the reversibility of caloric hypo-excitability in case of LC-BPPV after liberatory maneuver. On the other hand, Molina et al [8] have used caloric testing as a monitoring tool. They have found that 25% of patients with BPPV (16 of 54) had canal paresis at the diagnosis and 16% (9 of 56) still had canal paresis 1 y later.…”

Section: Discussionmentioning

confidence: 99%

“…They have reported that canal paresis was not associated with a lower outcome to repositioning maneuver. It was interesting to observe the normalization of caloric responses over time with the resolution of positional symptoms [8] .…”

Section: Discussionmentioning

confidence: 99%

Caloric Analysis of Patients with Benign Paroxysmal Positional Vertigo

Yetışer

İnce

2017

Int Adv Otol

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Original Article INTRODUCTIONPositional vertigo following sudden head motion in patients with benign paroxysmal positional vertigo (BPPV) is assumed to be due to freely floating otoconia inside the semicircular canals or those adhering to the cupula which make labyrinth sensitive to gravitational forces [1] . The majority of patients have quick relief of symptoms after repositioning maneuvers, although underlying pathology is obscure. Origin of these deposits is claimed to be due to degeneration of utricular neuroepithelium. Functional studies are needed to exclusively detect possible organic pathology of the utricule. Innervation of utricule is provided by superior vestibular nerve which also collects impulses from lateral and superior semicircular canals. The inferior vestibular nerve is connected to the posterior semicircular canal and the saccule.Caloric testing was first studied by the Nobel Prize winner Robert Barany in 1906, and later it was introduced to the otologic practice by Fitzgerald and Hallpike [2] in 1942. Videonystagmograpy (VNG) with caloric stimulation has been widely used in the analysis of severity of vestibular disorders. It reflects the degree to which the vestibular system is responsive and how symmetric the responses are between left and right. Caloric irrigation through the ear canal selectively stimulates the lateral canal [3] . However, studies indicate the contribution of other semicircular canals to the final response. Gacek et al. [4] have found severe dysfunction after caloric stimulation in seven patients who had singular neurectomy. Sensitivity of caloric stimulation to detect the vestibular pathology is subject to discussion [5] . Some problems may remain undiagnosed unless they cause severe vestibular dysfunction. The aim of this study is to analyze the incidence of caloric hypo-excitability, to investigate the role of symptom duration, and to compare the caloric responses in patients with lateral canal (LC-BPPV) and posterior canal (PC-BPPV). MATERIALS and METHODS MATERIALS and METHODS:A prospective study was conducted in 65 patients with BPPV (20 LC and 45 PC) who were subjected to caloric testing. Average slow-phase velocity and nystagmus duration were analyzed. RESULTS:Caloric hypo-excitability was 20.4%. It was more evident in patients with apogeotropic-type LC-BPPV. The comparison of average slowphase velocity of the nystagmus and nystagmus duration between selected types of BPPV for pathologic, non-pathologic, and the control ears after warm and cold stimulation was not statistically significant (p>0.05). No correlation was found between caloric results and symptom duration (p>0.05). CONCLUSION:Some patients presented caloric hypo-excitability. Reliability of caloric testing to differentiate the ear with normal and abnormal vestibular function in different types of BPPV was low. No difference was found in the analysis of the impact of symptom duration. Caloric testing is not an ideal tool to study BPPV.

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Monitoring of Caloric Response and Outcome in Patients With Benign Paroxysmal Positional Vertigo

Abstract: Canal paresis is not associated with a lower outcome to repositioning.

Cited by 17 publications

References 11 publications

Posturografia do Balance Rehabilitation Unit (BRU TM) na vertigem posicional paroxística benigna

Posturografia do Balance Rehabilitation Unit (BRU TM) na vertigem posicional paroxística benigna

Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study

Caloric Analysis of Patients with Benign Paroxysmal Positional Vertigo

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