Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients

Teggi, Roberto; Guidetti, Riccardo; Gatti, Omar; Guidetti, G

doi:10.14639/0392-100x-n1233

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…Age and sex were not significantly associated with higher recurrence rates, though female sex had a tendency (p < 0.1). Existing literature find contradictory results in regard to sex and age, as some find female sex and advanced age as risk factors (36,39,40), while others do not (34,37,41,42). Other risk factors include hypertension, hyperlipidemia, vitamin D deficiency and osteoporosis (34,41,42), which are also known risk factors of BPPV occurrence (43).…”

Section: Discussionmentioning

confidence: 98%

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Seven years of experience with treatment of benign paroxysmal positional vertigo with a mechanical rotational chair

et al. 2022

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BackgroundThroughout the last decade, several mechanical rotational chairs have been developed for diagnostics and treatment of patients with a typical case history of benign paroxysmal positional vertigo. Sparse evidence, however, exists in terms of diagnostic accuracy and treatment efficiency with these mechanical rotational chairs. Also, recommendations for optimal use of these chairs are yet to be determined.ObjectivePrimary objective was to evaluate overall treatment of benign paroxysmal positional vertigo with a mechanical rotational chair and secondary objectives included description of patient- and BPPV characteristics, determination of subjective and objective outcomes, as well as analyzation of recurrence- and recurrence-related risk factors following successful treatment.MethodsRetrospective cohort study with 635 patients diagnosed with benign paroxysmal positional vertigo and treated by means of a mechanical rotational chair during a 7-year period from 2014 to 2021 at a tertiary University hospital. Patient- and disease-specific characteristics, treatment and recurrence data were collected through reviewing of patient records.ResultsThe mean number of required treatments was 2.7 when accounting for a six percent treatment failure rate (defined as a need of more than 10 treatments), and 3.7 when not. Bilateral mono-canal affection required 3.8 treatments, unilateral multi-canal 3.5 treatments, and the combination of bilateral and multi-canal affection 5.2 treatments. All these scenarios were associated with significantly higher numbers of required treatments when compared to unilateral mono-canal affection, which required 1.9 treatments. The overall recurrence rate was 25.4 percent.ConclusionA mechanical rotational chair provides successful treatment of benign paroxysmal positional vertigo. Mechanical rotational chairs should primarily be reserved for the treatment of retractable and atypical benign paroxysmal positional vertigo patients. Many aspects of the optimal use of these chairs still require elaborative assessment.

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Section: Discussionmentioning

confidence: 98%

“…Our study found no difference in BPPV recurrence rates between primary and secondary etiologies. Other studies have assessed individual secondary etiologies, but there are found no consistent findings (39)(40)(41)(42).…”

Section: Discussionmentioning

confidence: 99%

Seven years of experience with treatment of benign paroxysmal positional vertigo with a mechanical rotational chair

et al. 2022

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“…(2) Younger participants have less difficulty learning geometrically complex 3-D head movements 8 . (3) Recurrence and residual symptoms requiring additional management are more frequent in elderly participants [26][27][28] . Although clinically irrelevant, the study results may change if young participants were exclusively recruited.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of an inertial measurement unit sensor-based guiding system for benign paroxysmal positional vertigo treatment: A pilot study

Pastor

Kwon

Joo

et al. 2023

Sci Rep

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Performing an accurate canalith repositioning procedure (CRP) is important for treating benign paroxysmal positional vertigo, because inadequate rotational head angles can result in ineffective otolith mobilization and consequent treatment failure. Specialists-guided Epley maneuver reportedly had mean errors of 13.7°–24.4° while they were significantly larger (40.0°–51.5°) when self-administered. Similar results were obtained for the Barbeque maneuver: mean errors were 9.2°–13.0° by the specialists while they were significantly larger (22.9°–28.6°) when self-administered. Our study aimed to validate the feasibility of an inertial measurement unit sensor-based CRP (IMU-CRP) by analyzing the differences in accuracy in the rotational angles, comparing them with education-based conventional CRP (EDU-CRP). A pilot validation was also performed by analyzing the treatment success rate of IMU-CRP in patients with BPPV. This single-institution prospective, comparative effectiveness study examined 19 participants without active vertigo or prior knowledge of benign paroxysmal positional vertigo and CRP. Participants conducted the Epley and Barbeque roll maneuvers without and with auditory guidance (EDU-CRP vs. IMU-CRP, respectively) twice, and head rotation accuracies were compared. Differences in target angles based on the American Academy of Otolaryngology-Head and Neck Surgery guidelines were considered errors. For BPPV participants, treatment success was assessed based on the presence or absence of nystagmus, vertigo, and dizziness. For all the Epley and Barbeque roll maneuvers steps, the absolute errors were smaller for IMU- than for EDU-CRPs, with significant differences in steps 2–4 and 3–6 of the Epley and Barbeque roll maneuvers, respectively. A learning effect was found in steps 4 and 5 of the Barbeque roll maneuver but not in the Epley maneuver. The treatment success rates after 1 h were 71.4% and 100% for the Epley and Barbeque roll maneuvers, respectively. Real-time feedback on head rotation angles induced more appropriate movements in the Epley and Barbeque roll maneuvers. A guiding device based on head monitoring providing real-time auditory feedback may increase the self-administered CRP success rates in treating benign paroxysmal positional vertigo.

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“…Conversely, in a 2015 study, Sari [11] found no difference in the level of anti-thyroid antibodies between the BPPV group and the control groups. In 2021, Teggi and colleagues [12] published a study on the role of vascular disorders, migraines, and antithyroid antibodies in patients with recurrent BPPV. They found a higher level of antibodies in the female population, which is already more prone to BPPV and its recurrences.…”

Section: Hypothyroidism and Bppvmentioning

confidence: 99%

Statistical Associations between Vestibular Pathologies and Hypothyroidism: A Retrospective Study

Bougerolle,

El Khiati,

El Ahmadi

et al. 2024

JCM

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The association between vestibular pathologies and thyroid hormone disorders has been known for several decades. However, very little information is available on the types of vestibular symptoms that may be affected by altered thyroid hormone levels. The aim of this study was to provide patient data in order to identify statistical associations between vestibular pathologies and thyroid hormone disorders. A retrospective review of the records of 422 patients seen for physiotherapy treatment of vertigo was carried out. Statistical analysis of the data was performed using logistic regression, providing Chi2 and Odds Ratio statistics. Our results show that hypothyroidism statistically significantly increases the expression of certain symptoms, such as vestibular instability and gait disorders, in vestibular pathologies such as Menière’s disease or central vertigo. By analyzing patient data, our study provides new evidence of dependence between altered thyroid status and the expression of vestibular pathologies.

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Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients

Cited by 11 publications

References 33 publications

Seven years of experience with treatment of benign paroxysmal positional vertigo with a mechanical rotational chair

Seven years of experience with treatment of benign paroxysmal positional vertigo with a mechanical rotational chair

Feasibility of an inertial measurement unit sensor-based guiding system for benign paroxysmal positional vertigo treatment: A pilot study

Statistical Associations between Vestibular Pathologies and Hypothyroidism: A Retrospective Study

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