Effects of Customized Vestibular Rehabilitation on Static balance among Adults with Benign Paroxysmal Positional Vertigo (Kesan Rehabilitasi Vestibular Disesuaikan Ke Atas Keseimbangan Static Dalam Kalangan Dewasa Dengan Masalah Benign Paroxysmal Positional Vertigo) / Jurnal Sains Kesihatan Malaysia

@#The aim of this study was to detemine the effectiveness of Customized vestibular rehabilitation (CVR) in addition to the standard Canalith repositioning maneuver (CRM) on static balance among adults with posterior canal Benign Paroxysmal Positional Vertigo (BPPV). In this randomised controlled trial, 28 adults with idiopathic unilateral posterior canal BPPV were randomized to either the control or experimental group. The experimental group (n=14, mean age: 50.71±9.88 years) received CVR in addition to CRM, and the control group (n=14, mean age: 54.36±8.55 years) received only CRM for 6 weeks. Measurements of static balance (postural sway) using a portable kinematic sensor were performed at baseline, four and six weeks after treatment for both groups while standing on firm and foam surface with eyes open (EO) and closed (EC). Only standing on foam surface with EC was observed to have a significant interaction effect, F (2, 52) =5.28, p<0.05. This suggest that the groups were affected differently by the intervention and greater improvement was demonstrated in the experimental group. Post hoc test showed that a significant difference (p<0.05) in static balance was shown between baseline and 6th week after intervention. The results of our study indicate that CVR in addition to CRM improved static balance in adults with UPC BPPV at 6th week after intervention for persons with BPPV.

Management of Benign Paroxysmal Positional Vertigo / 대한평형의학회지

Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by head positional changes. BPPV is one of the most common causes of recurrent vertigo. BPPV results from abnormal stimulation of the cupula within any of the three semicircular canals by free-floating otoliths (canalithiasis) or otoliths adhered to the cupula (cupulolithiasis). Spontaneous recovery occurs frequently even with conservative treatment. However, canalith repositioning maneuvers are believed to be the best way to treat BPPV by moving the canaliths from the semicircular canal to the vestibule. Various treatment methods of posterior, superior, and lateral canal BPPV are discussed in this review.

Therapeutic effect canalith repositioning maneuver combined with Chinese and western medicine of treating benign paroxysmal positional vertigo / 中国基层医药

ObjectiveTo observe the therapeutic effect and recurrence of treating Benign Paroxysmal Positional Vertigo(BPPV) by the treatment that combined Canalith Repositioning Maneuver(CRM) with Chinese and Western medicine.MethodsCollecting 40 cases suffered from BPPV,and randomized controlled method was used.Control group:20 cases( using Western and Chinese medicine),treatment group:20cases( using Western and Chinese medicine wrbined with CRM),judge the effect after 7days and telephone followed up 3 months,inquiring about recurrence situation.ResultsCure rate of treatment group was 90％,total effective rate was 100％ which was higher than the control group which was 50％,the total effective rate was 95％ (P ＜0.001 ) ;20 cases in treatment group followed up by telephone didn't recur.1 case in control group recurred,but got better after the treatment of CRM.ConclusionCRM which was effective,safe,simple and convenient to treat BPPV could be used as the preferred treatment for BPPV,if combined with Chinese and western medicine,it could significantly alleviate the symptoms and reduce the relapse.

Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by changes in head position. BPPV is the most common etiology of recurrent vertigo and is caused by abnormal stimulation of the cupula by free-floating otoliths (canalolithiasis) or otoliths that have adhered to the cupula (cupulolithiasis) within any of the three semicircular canals. Typical symptoms and signs of BPPV are evoked when the head is positioned so that the plane of the affected semicircular canal is spatially vertical and thus aligned with gravity. Paroxysm of vertigo and nystagmus develops after a brief latency during the Dix-Hallpike maneuver in posterior-canal BPPV, and during the supine roll test in horizontal-canal BPPV. Positioning the head in the opposite direction usually reverses the direction of the nystagmus. The duration, frequency, and symptom intensity of BPPV vary depending on the involved canals and the location of otolithic debris. Spontaneous recovery may be expected even with conservative treatments. However, canalithrepositioning maneuvers usually provide an immediate resolution of symptoms by clearing the canaliths from the semicircular canal into the vestibule.

Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by head position changes. BPPV is one of the most common causes of recurrent vertigo. BPPV results from abnormal stimulation of the cupula within any of the three semicircular canals by free-floating otoliths (canalithiasis) or otoliths adhered to the cupula (cupulolithiasis). Typical symptoms and signs of BPPV are evoked when the head is positioned so that the plane of the affected semicircular canal is spatially vertical and thus aligned with gravity. Paroxysm of vertigo and nystagmus develops after a brief latency during Dix-Hallpike maneuver in posterior canal BPPV and supine roll test in horizontal canal BPPV. Usually positioning the head in the opposite direction reverses the direction of the nystagmus. The duration, frequency, and intensity of symptoms of BPPV vary depending on the involved canals and the nature of otolithic debris. Spontaneous recovery occurs frequently even with conservative treatment, however, canalith repositioning maneuvers are believed to be the best way to treat BPPV by moving the canaliths from the semicircular canal to the vestibule.

Clinical Significance of Vestibular Evoked Myogenic Potentials in Patients With Benign Paroxysmal Positional Vertigo

OBJECTIVES: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV. SUBJECTS AND METHODS: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment. RESULTS: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the "no response" group, the number of times was considerably greater than those in the "response" group. CONCLUSIONS: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as "no response" in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV.

Therapeutic Efficacy and Prognostic Factors of Canalith Repositioning Maneuver in the Patients with Benign Paroxysmal Positional Vertigo

BACKGROUND AND OBJECTIVES: The purpose of this study were to evaluate the therapeutic efficacy of canalith repositioning maneuver (CRP) according to accompanying mastoid percussion and to investigate the prognostic factors that may affect successful repositioning maneuver and the recurrence of benign paroxysmal positional vertigo. MATERIALS AND METHOD: A total of 70 patients with canalith type BPPV visiting the dizziness clinic of Kangnam St. Mary's Hospital were included in this study. Variables identified for statistical analysis were patient's age, sex, maneuver method, number of involved canal, number of CRP and dizziness handicap inventory. RESULT: Overall success rate of CRP was 90%. The mean number of maneuver was 1.6 and the recurrence rate was 25.7% during the follow up period. Success rate of CRP (94.9%) was higher than maneuver without mastoid percussion (83.9%) though it was not statistically significant. Successful CRP group showed the significant less number of maneuvers at initial treatment session and less number of involved canal than failed CRP group at the time of one week-follow up visit. Patients with recurrence of BPPV had the more number of CRP during the period of previous BPPV. CONCLUSION: Therapeutic efficacy of CRP with mastoid percussion was higher than CRP without mastoid percussion though it was not statistically significant. Suggesting prognostic factors for effective CRP and recurrence were number of CRP and number of involved canal.