Post-COVID-19 Benign Paroxysmal Positional Vertigo

Abstract

Background. COVID-19 is a disease caused by a new strain of coronavirus (SARS-COVID-19). The WHO first learned about this new virus on December 31, 2019, following a report on a group of cases of “viral pneumonia” in Wuhan, People’s Republic of China, and declared a pandemic in March 2020. The disease was an almost complete unknown at the outset, but knowledge of its pathophysiology, clinical picture, and treatment options grew and developed rapidly. Objective. Dizziness is a very common symptom that patients report in routine clinical practice and one of the significant clinical manifestations of COVID-19. This short report investigated a possible connection between COVID-19 and benign paroxysmal positional vertigo (BPPV). Methods. We present two cases of benign paroxysmal positional vertigo (BPPV), which developed within two weeks of SARS-COVID-19 infection, manifesting with mild disease severity in early November 2020. Results. In both cases, the disease manifested by severe, short-lived attacks of vertigo, objective-circular type, with accompanying nausea and vomiting. The symptoms occurred when lying in bed and turning to the right and assuming an upright position. The diagnosis of posterior semicircular canal BPPV (PC-BPPV) was made based on a subjectively and objectively positive right-sided Dix–Hallpike test. Conclusions. The pathophysiology of post-COVID BPPV is probably similar to that of other viral infections, with some of its specificities such as inducing hypercoagulation and microthrombus formation, which can cause significant circulatory disorders possibly affecting its pathogenesis.

The Prevalence of Dizziness and Vertigo in COVID-19 Patients: A Systematic Review

“…Furthermore, in two of the four cases, where dizziness or vertigo was present, the COVID-19 patients were treated with antihistamines and/or steroids [ 32 , 35 ], and only one of these two cases received vestibular rehabilitation [ 35 ]. Maslovara et al reported two cases of post-BPPV following COVID-19 infection [ 43 ]. In 2 of the 14 OSs, dizziness was distinguished from vertigo.…”

Pandemi Sürecinde Bulunmanin Benign Paroksismal Pozisyonel Vertigo İle İlişkisi Var Mı?

“…BPPV was determined more often in the current study females, consistent with that study. In another study that showed that BPPV developed after COVID-19 infection, it was reported that the effect on the inner ear blood supply associated with microthrombus and hypercoagulation could be responsible in the pathophysiology (7).…”

“…In the current study, the predominance of female gender, the prolonged bedrest of patients associated with the pandemic, the greater number of patients who had not had a previous attack, and that the majority of the patients were determined with BPPV following COVID-19 infection, suggest that there could be a relationship between BPPV and the COVID-19 pandemic. Probable reasons for this could be the restricted physical activity of elderly patients because of the pandemic precautions, a more sedentary lifestyle because of various restrictions related to the pandemic, prolonged bedrest of patients who had contracted COVID-19 infection, the viral load associated with the pandemic (13), direct damage to the peripheral vestibular system caused by the viral infection (5), and inner ear blood supply affected by the virus (7).…”

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

“…Recently in the literature, cases reports have been published where patients developed BPPV after COVID-19 infection. Hence, it is important that patients who have dizziness after COVID-19 infection should be assessed for BPPV, and potentially curative treatment can be provided [17].…”