Study on the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo by SRM-vertigo diagnosis system / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo（HC-BPPV） by SRM-vertigo diagnosis system. Methods:A total of 406 patients diagnosed with HC-BPPV from Nov 2021 to Nov 2022 were enrolled by rapid axial roll test and Dix-Hallpike in the department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups by hospital card numbers, in which the numbers that were odd were considered as group A, and the numbers that were even were considered as group B. The group A underwent two circles of Barbecure repositioning procedure by SRM-vertigo diagnosis system, while the group B underwent two circles Barbecure combined with Epley repositioning procedure by SRM-vertigo diagnosis system. The treatment was stopped on the next day when two groups of patients were cured, and those who were not cured will continue treatment with the same method. Results:The cure rate of group A was 83.41%, and the cure rate of group B was 80.51%, the difference between the two groups was not-statistically significant difference（P>0.05）. The rate of residual dizziness of group A was 23.30%, the rate of residual dizziness of group B was 11.46%, the difference between the two groups was statistically significant（P<0.05）. Conclusion:The Barbecure combined with Epley otoliths repositioning maneuver by SRM-vertigo diagnosis system can significantly reduce the rate of residual dizziness after the treatment of HC-BPPV, and improve the quality of life of patients.

Therapeutic observation on horizontal penetration needling for residual dizziness after repositioning maneuver in patients with benign paroxysmal positional vertigo / 中国针灸

OBJECTIVE@#To observe the effect of horizontal penetration needling at vertigo auditory area and balance area on residual dizziness after successful repositioning maneuver in patients with benign paroxysmal positional vertigo (BPPV).@*METHODS@#Sixty-six patients with residual dizziness after successful repositioning maneuver for BPPV were randomly divided into an observation group (34 cases, 1 case dropped off) and a control group (32 cases, 2 cases dropped off). The patients in the observation group were treated with horizontal penetration needling at vertigo auditory area and balance area, once every other day; three times were taken as a course of treatment, and two courses of treatment were given. The patients in the control group received no acupuncture and medication. The dizziness handicap inventory (DHI) and visual analogue scale (VAS) scores were observed before treatment and after 1 and 2 courses of treatment.@*RESULTS@#Except for the emotional score of DHI in the control group after 1 course of treatment, the sub item scores and total scores of DHI and VAS scores in the two groups after treatment were lower than those before treatment (@*CONCLUSION@#Whether acupuncture or not, residual dizziness after repositioning maneuver for BPPV can be relieved within 2 weeks; horizontal penetration needling at vertigo auditory area and balance area could improve dizziness symptoms and shorten the course of disease.

Mareo residual, una condición clínica frecuente posterior a maniobra de reposición exitosa en vértigo posicional paroxístico benigno: una revisión / Residual dizziness, a frequent clinical condition following successful repositioning maneuver for benign paroxysmal positional vertigo: a review

El vértigo posicional paroxístico benigno (VPPB) es reconocido como la principal causa de vértigo de origen periférico en adultos, ya que, si bien la etiología del VPPB aún no se ha demostrado plenamente y se clasifica como la mayoría de los casos, se puede identificar el desprendimiento de otolitos y su desplazamiento en uno de los tres canales semicirculares. Una anamnesis cuidadosa puede abordar el diagnóstico clínico del VPPB, pero la confirmación se obtendrá por medio de maniobras de diagnóstico especificas de acuerdo a cuál de los canales está involucrado. Este trastorno altera la capacidad de llevar a cabo actividades de la vida cotidiana que determinan un aumento significativo en el riesgo de caídas y las consiguientes lesiones. La mayoría de los pacientes se recuperan después del tratamiento, sin embargo, hasta dos tercios de éstos pueden percibir inestabilidad prolongada, aturdimiento y malestar definidos como mareo residual. Esta sintomatología residual después de la resolución del VPPB es variable entre los pacientes, siendo el tiempo de duración de los síntomas residuales de aproximadamente de 1 a 3 semanas, existiendo algunos pacientes que pueden recuperarse más tardíamente. En esta revisión analizaremos el mareo residual, describiendo su expresión clínica, diagnóstica, fisiopatológica y tratamientos actuales de esta entidad clínica.

Benign paroxysmal positional vertigo (BPPV) is recognized as the main cause of peripheral vertigo in adults, although the etiology of BPPV has not yet been fully demonstrated and is classified as idiopathicin most cases, detachment of otoliths and their displacement in one of the three semicircular canals can be identifie. A careful history can address the clinical diagnosis of BPPV, but confirmation will be obtained through specific diagnostic maneuvers according to which canal is involved. This disorder alters the ability to carry out activities of daily living that determine a significant increase in the risk of falls and consequent injuries. Most patients recover after treatment, however, up to two thirds of these patients may perceive prolonged instability, dizziness and discomfort defined as residual dizziness. This residual symptomatology following BPPV resolution is variable among patients, the duration of residual symptoms can last 1 to 3 weeks, with some patients may recover later on. In this review, we will analyze residual dizziness, describing its clinical presentation, diagnosis, pathophysiology and current treatments of this clinical entity.

Analysis of Risk Factors for Residual Dizziness Patients with Benign Paroxysmal Positional Vertigo / 听力学及言语疾病杂志

Objective To study the incidence and duration of residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo(BPPV) and the clinical factors associated with the residual dizziness.Methods A total of 202 cases of confirmed BPPV patients,61 males and 141 females with the average age of 54.78± 13.71 years old,were followed up for 2 months after successful particle repositioning.The incidence and duration of residual dizziness were analyzed.The risk factors for residual dizziness were analyzed by logistic regression.Results A total of 202 cases of confirmed BPPV were included in this study,and 113 cases complained of residual dizziness.Over the time,residual dizziness disappeared gradually.The differences of the age,the duration of vertigo before treatment,recurrent,and underlying diseases between the two group were significant (P ＜0.05),while the side,the gender,the incubation period of BPPV,the duration time of BPPV,and the types of canals were not associated with the residual dizziness(P＞0.05).The logistic regression analysis showed that the duration of vertigo before treatment and the age were the risk factors for residual dizziness.Conclusion More than half of the patients included in this study complained of residual dizziness after particle repositioning,and the symptoms disappeared naturally.The duration of vertigo before treatment and the age were the risk factors for residual dizziness.

Cause analysis and duration of residual dizziness after successful canalith repositioning maneuver in patients with benign paroxysmal positional vertigo / 第二军医大学学报

Objective To explore the duration of residual dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV) and the possible causes. Methods A total of 60 BPPV patients with successful canalith repositioning maneuver were recruited from Department of Neurology of Changzheng Hospital of Second Military Medical University from Oct. 2016 to Jan. 2017. Visual Analogue Scale (VAS), Hospital Anxeity and Depression Scale (HADS), subjective visual vertical (SVV) and ocular vestibular evoked myogenic potential (oVEMP) were evaluated in the BPPV patients suffering from residual dizziness after successful canalith repositioning maneuvers, and their residual dizziness duration was recorded. According to the residual dizziness duration, the patients were divided into short-term group (≤7 d) and long-term group (7 d), and the difference of clinical characteristics was analyzed. Results There were 36 (60.00%) BPPV patients with residual dizziness after successful canalith repositioning maneuver, and 22 (61.11%) cases recovered within 1 week, and 14 lasted for more than 1 week. Compared with the long-term group, VAS and HADS scores were significantly lower (all P0.05) and reverse deviation incidence of SVV were higher in the short-term group (63.6% [14/22] vs 28.6% [4/14], χ2＝4.21, P＝0.04). There was no significant difference in oVEMP abnormality rate between the two groups. Conclusion The transient otolithic dysfunction and central readaption play a role in the occurrence of residual dizziness of the BPPV patients after successful canalith repositioning maneuver, and the residual dizziness usually has mild symptoms and a shorter duration. The residual dizziness with a duration longer than 7 days is associated with mental and emotional factors.

The Efficacy of DizzyFIX for Residual Dizziness after Successful Repositioning Maneuvers in Posterior Benign Paroxysmal Positional Vertigo / 대한평형의학회지

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.