Benign paroxysmal positional vertigo recurrence and persistence

Ricardo S Dorigueto, Karen R Mazzetti, Yeda Pereira L Gabilan, Fernando Freitas Ganança, Ricardo S Dorigueto, Karen R Mazzetti, Yeda Pereira L Gabilan, Fernando Freitas Ganança

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders.

Aim: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year.

Study design: longitudinal contemporary cohort series.

Materials and methods: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR) protocol was applied in cases of persistent BPPV.

Results: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR.

Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.

References

    1. López-Escámez JA, Gamiz MJ, Fernandez-Perez A, Gomez-Finana M, Sanchez-Canet I. Impact of treatment on health-related quality of life in patients with posterior canal benign paroxysmal positional vertigo. Otol Neurotol. 2003;24(4):637–641.
    1. Schuknecht HF, Ruby RR. Cupulolithiasis. Adv Otorhinolaryngol. 1973;20:434–443.
    1. Semont A, Freyss G, Vitte E. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol. 1988;20:290–293.
    1. Epley JM. The canalith repositioning procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992;107(3):399–404.
    1. Gacek RR. Further observations on posterior ampullary nerve transection for positional vertigo. Ann Otol Rhinol Laryngol. 1978:300–306.
    1. Velde GM. Benign paroxysmal positional vertigo Part I: Background and clinical presentation. 1999;43(1):31–40.
    1. Katsarkas A. Paroxysmal positional vertigo: An overview and the deposits repositioning maneuver. Am J Otol. 1995;16(6):725–730.
    1. Ganança MM, Albernaz PLM, Caovilla HH, Ito YI, Ganança FF, Pontes PAL, et al. Reabilitação do paciente labiríntico por meio de exercícios optovestibulares. 87° Encontro de Especialistas Ache - vertigens, náuseas e tinnitus. 1989:357.
    1. Shepard NT, Telian SA, Smith-Wheelock M, Raj A. Vestibular and balance rehabilitation therapy. Ann Otol Rhinol Laryngol. 1993;102(3 pt 1):198–205.
    1. Pedalini MEB, Bittar RSM, Formigoni LG, Cruz OLS, Bento RF, Miniti A. Reabilitação vestibular como tratamento da tontura:experiência com 116 casos. Arq Fund Otorrinolaringol. 1999;2(2):74–78.
    1. Black FO, Angel CR, Pesznecker SC, Gianna C. Outcome analysis of individualized vestibular rehabilitation protocols. Am J Otol. 2000;21:543–551.
    1. Bittar RSM, Pedalini MEB, Lorenzi MC, Formigoni LG. Treating vertigo with vestibular rehabilitation:results in 155 patients. Rev Laryngol Otol. Rhinol (Bord) 2002;123:61–65.
    1. Silveira SR, Taguchi CK, Ganança FF. Análise comparativa de duas linhas de tratamento para pacientes portadores de disfunção vestibular periférica, com idade superior a sessenta anos. Rev Acta Awho [periódico online] 2002 [citado 2002 fev 14];(junho 23):[14 telas]. Encontrado em URL:.
    1. Medeiros IRT. Avaliação clínica e posturográfica do tratamento das afecções vestibulares periféricas na infância pela reabilitação vestibular [tese] Faculdade de Medicina da Universidade de São Paulo-FMUSP.; São Paulo: 2003.
    1. Gabilan YPL. Fisioterapia aquática em pacientes com síndrome vestibular periférica deficitária unilateral. [tese] Universidade Federal de São Paulo - UNIFESP.; São Paulo: 2004.
    1. Gabilan YPL, Perracini MR, Munhoz MSL, Ganança FF. Fisioterapia aquática para reabilitação vestibular. Acta Orl. 2006;24(1):23–28.
    1. Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med. 1952;45(6):341–354.
    1. Herdman SJ, Tusa RJ. Diagnosis and treatment of benign paroxysmal positional vertigo. Schaumburg (Illinois): ICS Medical Corporation. 1999:28.
    1. Parnes LS, Price-Jones RG. Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol. 1993;102(5):325–331.
    1. Lempert T, Wilck KT. A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope. 1996;106:476–478.
    1. Herdman SJ, Tusa RJ. Complications of the canalith repositioning procedure. Arch Otolaryngol. 1996;122(3):281–286.
    1. Castro AS, Gazzola JM, Natour J, Ganança FF. Brazilian version of the dizziness handicap inventory. Pró Fono. 2007;19(1):97–104.
    1. Lanska DJ, Goetz CG. Romberg's sign: development, adoption and adaptation in the 19th century. Neurology. 2000;55:1201–1206.
    1. Balogun JA, Akindele KA, Nihinlola JO, Marzouk DK. Age-related changes in balance performance. Disabil Rehabil. 1994;16(2):58–62.
    1. Dorigueto RS, Ganança MM, Gazzola M, Ganança FF. Impacto do tratamento na qualidade de vida de pacientes com vertigem posicional paroxística benigna primaria e secundaria. In: 5o Congresso Triológico de Otorrinolaringologia, 2007, Brasília. Rev Bras Otorrinolaringol. 2007;73:101.
    1. Guzmán PV, Zeigelboim BS, Hassan SE, Frazza MM, Diniz Jr J, Caovilla HH. A manobra de Brandt-Daroff modificada na reabilitação da vertigem postural. Acta Awho. 2000;19(4):189–192.
    1. Macias JD, Lambert KM, Massingale S, Ellensohn A, Fritz JA. Variables affecting treatment in benign paroxysmal positional vertigo. Laryngoscope. 2000;110:1921–1924.
    1. Atlas JT, Parnes LS. Benign paroxysmal positional vertigo: mechanism and management. Curr Opin Otolaryngol Head Neck Surg. 2001;9:284–289.
    1. Baloh RW, Honrubia V, Jacobson K. Benign positional vertigo. Neurology. 1987;37:371–378.
    1. Gross EM, Ress BD, Viirre ES, Nelson JR, Harris JP. Intractable benign paroxymal positional vertigo in patients with Ménières disease. Laryngoscope. 2000;110:655–659.
    1. Hall SF, Ruby RRF, McClure JA. The mechanisms of benign paroxysmal vertigo. J Otolaryngol. 1979;8(2):151–158.
    1. Welling DB, Parnes LS, OBrien BBA, Bakaletz LO, Brackmann DE, Hinojosa R. Particulate matter in the posterior semicircular canal. Laryngoscope. 1997;107(1):90–94.
    1. Zucca GJ. VS Why do BPPV episodes recover spontaneously? J Vest Res. 1998;8(4):325–329.
    1. Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope. 1997;107:607–613.
    1. Merchant SNSH. (1988). Vestibular atelectasis. Ann Otol Rhinol Laryngol. 1988;97:565–576.
    1. Schratzenstallera B, Wagner-Manslaub C, Alexioua C, Arnolda W. High-resolution three-dimensional magnetic resonance imaging of the vestibular labyrinth in patients with atypical and intractable benign positional vertigo. ORL. 2001;63:165–177.
    1. Norré ME, Beckers A. Comparative study of two types of exercise treatment for paroxysmal positioning vertigo. Adv Otorhinolaryngol. 1988;42:287–289.
    1. Willen C, Sunnerhagen K, Grimby G. Dynamic water exercise in individuals with late poliomyelitis. Arch Phys Med Rehabil. 2001;82:66–72.
    1. Geigle PR, Cheek WL, Gould ML, Hunt HC, Shafiq B. Aquatic physical therapy for balance:the interaction of somatosensory and hydrodynamic principles. J Aquatic Phys Ther. 1997;5(1):4–10.
    1. Martin J. The Halliwick method. Physiotherapy. 1981;67:288–291.
    1. Campion MR. In: Hidroterapia: princípios e prática. Campion MR, editor. Manole; São Paulo: 2000. Física básica: forma e densidade; pp. 14–22.
    1. Herdman SJ. Role of vestibular adaptation in vestibular rehabilitation. Otolaryngol Head Neck Surg. 1998;119(1):49–54.
    1. Becker BE. In: Reabilitação Aquática. Ruoti RG, Morris DM, Cole AJ, editors. Manole; São Paulo: 2000. Princípios físicos da água; pp. 17–42.
    1. Suomi R, Koceja DM. Postural sway characteristics in women with lower extremity arthritis before and after an aquatic exercise intervention. Arch Phys Med Rehabil. 2000;81:780–785.
    1. Ganança MM, Munhoz MSL, Caovilla HH, Silva MLG, Ganança FF, Perracini MR, et al. In: Condutas na vertigem. Ganança MM, Munhoz MSL, Caovilla HH, Silva MLG, editors. Moreira; São Paulo: 2004. Conceitos e algoritmos terapêuticos. Jr;
    1. Horak FB, Shupert C. In: Reabilitação vestibular. Herdman SJ, editor. Manole; São Paulo: 2002. Função do sistema vestibular no controle postural; pp. 25–51.
Uncited Reference
    1. Helminski JO, Janssen I, Kotaspouikis D, Kovacs K, Sheldon P, McQueen K, Hain TC. Strategies to prevent recurrence of benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg. 2005;131(4):344–348.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe