Journal of Vestibular Research - Volume Pre-press, issue Pre-press

Authors: Power, Laura | Murray, Katherine | Szmulewicz, David J

Article Type: Research Article

Abstract: QUESTION: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of dizziness presenting to specialist vestibular centres and accounts for approximately 20–30% of referrals to these clinics. In spite of the amount of clinical knowledge surrounding its diagnosis and management, the treatment of BPPV remains challenging for even the most experienced clinicians. This study outlines the incidence of BPPV in a specialised vestibular physiotherapy clinic and discusses the various nuances encountered during assessment and treatment of BPPV. DESIGN: Observational Study PARTICIPANTS: 314 patients with various forms of Benign Paroxysmal Positional Vertigo (BPPV) INTERVENTION: …Canalith repositioning manoeuvres (CRP) for posterior canal (PC) or horizontal canal (HC) BPPV depending on the canal and variant of BPPV. OUTCOME MEASURES: Negative Dix-Hallpike (DHP) or Supine roll test (SRT) examination. RESULTS: In 91% of cases, PC BPPV was effectively treated in 2 manoeuvres or less. Similarly, 88% of HC BPPV presentations were effectively managed with 2 treatments. Bilateral PC, multiple canal or canal conversions required a greater number of treatments. There was no noticeable difference in treatment outcomes for patients who had nystagmus and symptoms during the Epley manoeuvre (EM) versus those who did not have nystagmus and symptoms throughout the EM. Nineteen percent of patients experienced post treatment down-beating nystagmus (DBN) and vertigo or “Otolithic crisis” after the first or even the second consecutive EM. CONCLUSION: Based on the data collected, we make several clinical recommendations for assessment and treatment of BPPV. Firstly, repeated testing and treatment of BPPV within the same session is promoted as a safe and effective approach to the management of BPPV with a low risk of canal conversion. Secondly, vertigo and nystagmus throughout the EM is not indicative of treatment success. Thirdly, clinicians must remain vigilant and mindful of the possibility of post treatment otolithic crisis following the treatment of BPPV. This is to ensure patient safety and to prevent possible injurious falls. Our results challenge several clinical assumptions about the assessment and treatment of BPPV including the utility of certain markers of treatment success; hence influencing the current clinical guidelines and clinical practice and paving the way for future studies of the assessment and management of patients with BPPV. Show more

Keywords: Benign Paroxysmal Positional Vertigo (BPPV)

DOI: 10.3233/VES-190687

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-1, 2019

Authors: Lee, Ho-Won | Lim, Yong-Hyun | Kim, Sung-Hee

Article Type: Research Article

Abstract: Accumulating evidences show that the vestibular system contributes to cognitive function, including visuospatial ability, memory, and attention. Conversely, cognitive processes appear to affect the vestibular system. Based on the assumption that cognitive impairment correlates to increased perceived dizziness, we recruited 308 adults with cognitive decline from neurodegenerative disorders and administered neuropsychological tests and the Dizziness Handicap Inventory. Global cognitive measures did not correlate with increased dizziness, whereas attentional and visuospatial cognitive ability was correlated with scores of the Dizziness Handicap Inventory. Furthermore, patients with both cognitive impairment and postural instability experienced notably worse dizziness than those without postural instability, suggesting …that postural instability is an important determinant of dizziness. Show more

Keywords: Dizziness, cognition, posture, dementia, parkinsonism

DOI: 10.3233/VES-190686

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-7, 2019

Authors: Hüfner, Katharina | Sperner-Unterweger, Barbara

Article Type: Research Article

Abstract: The Barany society published recently the consensus document for the diagnostic criteria of persistent postural perceptual dizziness (PPPD). In this commentary we highlight the benefits of this new diagnosis and possible problems that can arise during the use of the criteria in day to day clinical practice at a University Clinic for Psychosomatic Medicine. The diagnostic criteria of PPPD are compared to those of somatic symptom disorder and bodily distress disorder. We think that a discussion from a psychosomatic point of view is important to improve the understanding between different specialties and how PPPD fits into the broader framework of …psychosomatic medicine. Show more

DOI: 10.3233/VES-190679

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-3, 2019

Article Type: Letter

DOI: 10.3233/VES-190680

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-3, 2019

Authors: Micarelli, Alessandro | Viziano, Andrea | Alessandrini, Marco

Article Type: Letter

DOI: 10.3233/VES-180664

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. -, 2019

Authors: Rosiak, Oskar | Jozefowicz-Korczynska, Magdalena

Article Type: Letter

DOI: 10.3233/VES-180665

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-2, 2019

Authors: Lopez-Escamez, Jose A. | Attyé, Arnaud

Article Type: Research Article

DOI: 10.3233/VES-180663

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-4, 2019

Authors: Gürkov, Robert

Article Type: Research Article

DOI: 10.3233/VES-180662

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-7, 2019

Authors: Gürkov, Robert | Barath, Krisztina | de Foer, Bert | Fukushima, Munehisa | Gluth, Michael | Hornibrook, Jermy | Perez-Fernandez, Nicolas | Pyykkö, Ilmari | Sone, Michihiko | Usami, Shin-Ichi | Wang, Wuqing | Zou, Jing | Naganawa, Shinji

Article Type: Article Commentary

DOI: 10.3233/VES-190662

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-7, 2019