Residual Dizziness after Successful Repositioning Treatment in Patients with Benign Paroxysmal Positional Vertigo

Abstract

Background and PurposeᄏBenign paroxysmal positional vertigo (BPPV) is the most common form of vertigo. Although the repositioning maneuver dramatically improves the vertigo, some patients complain of residual dizziness. We evaluated the incidence and characteristics of persistent dizziness after successful particle repositioning and the clinical factors associated with the residual dizziness.MethodsᄏWe performed a prospective investigation in 49 consecutive patients with confirmed BPPV. The patients were treated with a repositioning maneuver appropriate for the type of BPPV. Success was defined by the resolution of nystagmus and positional vertigo. All patients were followed up until complete resolution of all dizziness, for a maximum of 3 months. We collected data on the characteristics and duration of any residual dizziness and analyzed the clinical factors associated with the residual dizziness.ResultsᄏOf the 49 patients, 11 were men and 38 were women aged 60.4±13.0 years (mean ±SD), and 30 (61%) of them complained of residual dizziness after successful repositioning treatment. There were two types of residual dizziness: continuous lightheadedness and shortlasting unsteadiness occurring during head movement, standing, or walking. The dizziness lasted for 16.4±17.6 days (range=2-80 days, median=10 days). A longer duration of BPPV before treatment was significantly associated with residual dizziness (p=0.04).ConclusionsᄏResidual dizziness after successful repositioning was observed in two-thirds of the patients with BPPV and disappeared within 3 months without specific treatment in all cases. The results indicate that early successful repositioning can reduce the incidence of residual dizziness.

Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo in the elderly

“…We found a lower rate (36.6%) and duration (13.4 days) of residual dizziness than in another study [19], which reported 61% and 16.4 days, respectively; although we only Our results on the other hand are in accordance with previous studies reporting no correlation between residual dizziness and involved canal, gender, or number of repositioning maneuvers, while a correlation has been found with duration of vertigo before repositioning maneuvers [19,20].…”

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

“…In our sample we found a lower rate and a shorter duration of RD than in previously published works [10,11,15]; in our opinion, sociodemographic data (age of the patient, previous vestibular episodes) and the lack of a commonly accepted definition of RD may play a role in it. A recent study showed that both vertigo and dizziness, evaluated by VAS scales, decreased exponentially day by day after successful repositioning maneuvers but with different constants, suggesting the independence of the two ratings [16].…”

“…The causal factors are still under debate. RD has been related to the duration of vertigo before diagnosis and with the anxiety that patients develop regarding their condition [10,11]. …”

Anxiolytics reduce residual dizziness after successful canalith repositioning maneuvers in benign paroxysmal positional vertigo

“…However, some patients suffer from persistent, nonspecific dizzy symptoms, remnant floating sensation or anxiety, after successful CRPs. The residual dizziness has been attributed to remaining otoconial debris from incomplete repositioning, disorders of the otoliths that sense orientation in space, other vestibular lesions, or the longer time needed for central adaptation after particle repositioning [12]. However, none of the 73 patients in the current study either demonstrated residual positional nystagmus on follow-up examination or had other comorbid vestibular disorders.…”