ABSTRACT
BACKGROUND AND OBJECTIVE: Benign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle. MATERIALS AND METHODS: Air conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1-p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude. RESULTS: This study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week. CONCLUSIONS: oVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient's symptoms, which may be misleading due to a remission
ANTECEDENTES Y OBJETIVO: El vértigo posicional paroxístico benigno es el trastorno vestibular periférico más común. La canalolitiasis en el canal semicircular posterior es la enfermedad subyacente más común, que puede tratarse eficazmente mediante maniobras de reposicionamiento. Nuestra hipótesis sugiere que las maniobras exitosas pueden originar un reposicionamiento de la otoconia desplazada hacia el utrículo. MATERIALES Y MÉTODOS: El potencial miogénico evocado vestibular ocular (oVEMP) con conducción de aire, cuyo origen se piensa que se halla en el utrículo contralateral, se midió en 20 pacientes con vértigo posicional paroxístico benigno unilateral comparando la amplitud n1-p1 de pico a pico de los oídos afectados en 3 intervalos separados: previamente al tratamiento cuando se confirmó el nistagmo típico, inmediatamente después y transcurrida una semana de las maniobras de reposicionamiento, para confirmar el cambio de amplitud, de haberse producido. RESULTADOS: Este estudio reflejó un incremento considerable de la amplitud del oVEMP en los oídos afectados, tras las maniobras exitosas de reposicionamiento, que fue más significativa trascurrida una semana. CONCLUSIONES: El oVEMP puede utilizarse como prueba objetiva fiable para garantizar una maniobra exitosa, en lugar de la dependencia subjetiva de la sintomatología del paciente, que puede resultar engañosa debido a su remisión
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Benign Paroxysmal Positional Vertigo/physiopathology , Benign Paroxysmal Positional Vertigo/therapy , Patient Positioning/methods , Vestibular Evoked Myogenic Potentials , Prospective StudiesABSTRACT
BACKGROUND AND OBJECTIVE: Benign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle. MATERIALS AND METHODS: Air conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1-p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude. RESULTS: This study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week. CONCLUSIONS: oVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient's symptoms, which may be misleading due to a remission.
