Document Detail


Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form?
MedLine Citation:
PMID:  15477514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although head trauma is considered a common cause of benign paroxysmal positional vertigo (BPPV), clinical presentation and outcome of traumatic BPPV (t-BPPV) have not been systematically evaluated. OBJECTIVES: To compare the clinical presentation, patient's response to physical treatment, and outcome of patients with t-BPPV with those with the idiopathic form (i-BBPV). SETTING: Tertiary referral neuro-otology outpatient clinic. METHODS: We reviewed the clinical records of 247 consecutive patients with posterior canal BPPV during the years 1997 to 2000. All patients were diagnosed using the Dix-Hallpike test and treated using the particle repositioning maneuver. Patients with an onset of positional vertigo within 3 days of well-documented head trauma were included in the t-BPPV group. The outcome was compared with the outcome of 42 patients with i-BPPV who were similarly treated and followed up. RESULTS: Twenty-one (8.5%) of the 247 patients with BPPV fulfilled the diagnostic criteria for t-BPPV. The most common cause of head trauma was motor vehicle crash, documented in 57% of the cases; half of the patients additionally suffered from a whiplash injury. While the other causes were diverse, common falls were predominant. Only 2 of the patients involved in motor vehicle crashes experienced brief loss of consciousness. Sixty-seven percent of patients with t-BPPV required repeated physical treatments for complete resolution of signs and symptoms in comparison to 14% of patients with i-BPPV (P<.001). During a mean +/-SD follow-up of 21.7 +/- 9.7 months, 57% of t-BPPV patients and 19% of i-BPPV controls had recurrent attacks (P<.004). CONCLUSIONS: The nature and severity of the traumas causing t-BPPV are diverse, ranging from minor head injuries to more severe head and neck trauma with brief loss of consciousness. It appears that t-BPPV is more difficult to treat than i-BPPV, and also has a greater tendency to recur.
Authors:
Carlos R Gordon; Ronen Levite; Vitaly Joffe; Natan Gadoth
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  61     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-12     Completed Date:  2004-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1590-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Meir General Hospital, Kfar-Saba 44281, Israel. cgordon@post.tau.ac.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Craniocerebral Trauma / complications*,  rehabilitation
Eye Movements / physiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Nystagmus, Physiologic / physiology
Reflex, Vestibulo-Ocular / physiology
Retrospective Studies
Saccades / physiology
Treatment Outcome
Vertigo / classification,  diagnosis,  etiology*,  rehabilitation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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