Residual Dizziness after Successful Repositioning Maneuvers for Idiopathic Benign Paroxysmal Positional Vertigo

Abstract

Objective: To establish a possible causal factor for residual dizziness (RD) after successful repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). Materials and Method: Ninety consecutive patients with idiopathic BPPV were treated with repositioning maneuvers, and the rate of RD was assessed as well as clinical data. Posturography and assessment of anxiety levels were performed on patients reporting RD. Results were compared with a control group of BPPV patients of the sample after repositioning maneuvers and without RD. Results: Twenty-eight subjects (31.1%) reported RD on the second day after successful repositioning maneuvers. The mean duration of RD was 11.6 ± 3.9 days. Patients with RD presented a higher duration of BPPV (14.1 vs. 10.9 days, p = 0.01). A correlation was demonstrated between the duration of BPPV and duration of RD (p < 0.01). Subjects with RD presented increased body sways, above all in eyes-closed conditions. Conclusion: RD is mainly correlated with duration of vertigo in BPPV patients. Anxiety was demonstrated to play a role in increased body sways.

Impaired mental rotation in benign paroxysmal positional vertigo and acute vestibular neuritis

“…Both unilateral vestibular stimulation and unilateral failure of the vestibular endorgan create a vestibular tonic imbalance; however, this imbalance occurs at different levels of vestibular system activity (i.e., the trigger zone at the hair-cell afferent axon interface and the pars medialis of the utricular macula for GVS, vestibular nerve in VN and macula for BPPV; Lobel et al, 1998; Bense et al, 2001; Fitzpatrick and Day, 2004; Teggi et al, 2013). A similar issue was discussed by Bense et al (2004), who showed that VN is associated to a pattern of tonic cerebral metabolic changes which is not identical to that following vestibular stimulation through caloric testing and GVS (Bense et al, 2001; Lobel et al, 1998).…”

Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

“…Residual dizziness has also been reported as a complication of BPPV repositioning treatments [35,36,37]. Most of the patients in our research complained of residual dizziness immediately after the treatment, but the dizziness declined over time.…”

Indicaciones de la rehabilitación vestibular

“…Aunque en la actualidad se acepta que el tratamiento gold standard del VPPB son las maniobras de reposición canalicular, algunos pacientes manifiestan en las semanas posteriores a su recuperación con este tratamiento, síntomas de mareo e inestabilidad persistente sin nistagmo ni sensación vertiginosa en posiciones estáticas o dinámicas posiblemente en relación con la alteración de la información propioceptiva y visual [28,29]. La aparición de este cuadro se ha relacionado con factores tales como la edad, el tiempo de evolución del cuadro de VPPB [30,31] o con un componente de ansiedad. La rehabilitación vestibular en estos casos, especialmente en los pacientes de edad más avanzada, ha obtenido mejores resultados que con las maniobras de reposición como tratamiento único [29].…”