Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal's resolution be defined? Prospective observational study

Autor: E. Figuerola-Massana, Rocío González-Aguado, A.J. Martín-Mateos, Ángel Ramos-Macías, M G Álvarez-Morujo de Sande, Gloria Guerra-Jiménez, Esther Doménech-Vadillo, Emilio Domínguez-Durán, C. Morales Angulo, H. Galera-Ruiz
Rok vydání: 2018
Předmět:
Zdroj: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-LaryngologyCervico-Facial Surgery. 44(3)
ISSN: 1749-4486
Popis: OBJECTIVES To compare the outcome of the Epley maneuver (EM) in benign paroxysmal positional vertigo of the posterior canal (CSP-BPPV) depending on the definition used for recovery. DESIGN Multicenter observational prospective study. SETTING Otoneurology Units of 5 tertiary reference hospitals. PARTICIPANTS All patients presenting with unilateral CSP-BPPV assisted for 1-year period. EXCLUSION CRITERIA Spontaneous nystagmus, positive McClure-Pagnini maneuver, positive bilateral Dix-Hallpike maneuver (DHM), positive DHM for vertigo but negative for nystagmus and atypical nystagmus. MAIN OUTCOME MEASURES Response to EM was measured after 7 days in 3 different outcomes: disappearance of nystagmus during the DHM in the follow-up visit, disappearance of vertigo during the DHM and general status (GS) during daily life activities. RESULTS 264 patients were recruited (68 male/166 female, mean age 62 years). After the EM, nystagmus disappeared in 67% of them, vertigo in 54% and 36% were asymptomatic in their daily life. These outcomes were strongly correlated, but they were not concordant in a clinically significant group of cases; only the 26% of patients met all of them. The healing process follows the next sequence: negativization of positional nystagmus, then disappearance of positional vertigo and, finally, the improvement of GS during daily life activities. CONCLUSION Nowadays, healing criteria for the resolution of an PSC-BPPV episode have not been specifically defined yet. Provided that other otoneurological disorders have been ruled out, the next resolution criterion is proposed: absence of nystagmus and specifically during control DHM and disappearance of symptoms during daily life activities.
Databáze: OpenAIRE