Benign paroxysmal positional vertigo and different maneuvers for management

To study cases with positional vertigo who met criteria of benign paroxysmal positional vertigo BPPV in audiology unit Assiut university and determine the canal involvement, the type of BPPV whether canalithiasis or cupulolithiasis and evaluate the efficacy of different canalith repositioning maneuvers. Study group consists of 42 patients were diagnosed with BPPV, underwent history taking, ontological examination, neurological examination, basic audiological assessment, also patients underwent Dix-Hallpike and roll tests by infra red goggles video camera, and Electronystagmography. There were 42 patients were diagnosed with BPPV, 39 patients of them had PC-BPPV, three had HC-BPPV no AC-BPPV was found in the study group. The PC-BPPV were subdivided into canalithiasis and cupulolithiasis, it was found that 30 cases were canalithiasis and nine cases were cupulolithiasis, where all cases of HC-BPPV were canalithiasis. BPPV is the most common cause of positional vertigo and dizziness. The present study consisted of 42 BPPV patients. They are complaining of positional vertigo, which met the criteria of positional vertigo, with the characteristic positional provoked nystagmus. There were 39 patients of the 42 had posterior canal BPPV [92.86%], three cases had horizontal canal BPPV [7.14%]. The 30 patients with PC-BPPV canalithiasis were corrected with Epley's maneuver. The success rate was 86.6% after the 1[st] session of the Epley's maneuver. Eight patients of the PC-BPPV were cupulolithiasis, the success rate after the first Semont maneuver's was 55.6%, it's 77.8% after the 2[nd] session and its 88.9% after the 3[rd] session. The success rate of canalith repositioning maneuvers varies according the pathogenesis; it was very high in Eply's [96%] for canalithiasis than in Semont's for cupulolithiasis [88%]

interrelation of migraine, vestibular dysfunction and hearing impairment

Migraine is a relatively common neurological disorder. Neuro-otological symptoms were common in patients with migraines. The aim of this work is to identify the frequency of neuro-otological affection in migraine. The study includes forty-one patients with migraine, and 20 healthy volunteers. Each subject was submitted to full neurological, medical and audiological history and examination. Puretone audiometry, electronystagmography [ENG] tests, auditory brain stem response [ABR] and event related potentials [ERPs]. Dizziness was recorded in 56.1%, rotational vertigo in 31.7% and positional vertigo was occurred in 19.5%. Sense of imbalance, tinnitus and phonophobia were reported in 12.2%, 19.5%, and 29.3%, respectively. Abnormalities in at least one of ENG tests were found in 75.6% of patients that include abnormal results of positioning and positional in 34.1%, post head shaking test in 26.8%, saccade test in 19.5%, optokinetic test in 19.5%, pursuit test in 14.6%, unilateral caloric weakness test in 9.8% and spontaneous nystagmus test in 2.4%. Sensorineural hearing impairment was reported in 21.9%. Significant prolongation of mean interpeak latency of I-III of right ear at 90 dBHL with low repetition rate, III-V at 90 dBHL with high repetition rate and absolute latency of right wave V at 90 dBHL repetition rate compared with controls. No significant differences between patients and control in ERPs. Vestibular dysfunctions were frequently associated with common migraine also hearing impairment was reported in appreciable numbers of cases. Both central and peripheral vestibular affection were recorded in between attacks