Benign Paroxysmal Positional Vertigo

Benign positional vertigo may be a more common cause of falls in older people than we thought. It’s certainly worth looking for since it is treatable.

View

Background
The frequency and impact of undiagnosed benign paroxysmal positional vertigo (BPPV) in people identified with high falls risk has not been investigated.

Objective
To determine the frequency and impact on key psychosocial measures of undiagnosed BPPV in adult community rehabilitation outpatients identified with a high falls risk.

Design
A frequency study with cross-sectional design.

Setting
A Community Rehabilitation Program in Melbourne, Australia.

Subjects
Adult community rehabilitation outpatients with a Falls Risk for Older People in the Community Screen score of four or higher.

Methods
BPPV was assessed in 34 consecutive high falls risk rehabilitation outpatients using the Dix–Hallpike test and supine roll test. Participants were assessed for anxiety, depression, fear of falls, social isolation and loneliness using the Hospital Anxiety and Depression Scale, Falls Efficacy Scale-International and De Jong Gierveld 6-Item Loneliness Scale.

Results
A total of 18 (53%; 95% confidence interval: 36, 70) participants tested positive for BPPV. There was no significant difference between those who tested positive for BPPV and those who did not for Falls Risk for Older People in the Community Screen scores (P = 0.555), Hospital Anxiety and Depression Scale (Anxiety) scores (P = 0.627), Hospital Anxiety and Depression Scale (Depression) scores (P = 0.368) or Falls Efficacy Scale-International scores (P = 0.481). Higher scores for the De Jong Gierveld 6-Item Loneliness Scale in participants with BPPV did not reach significance (P = 0.056).

Conclusions
Undiagnosed BPPV is very common and associated with a trend towards increased loneliness in adult rehabilitation outpatients identified as having a high falls risk.

Author/s:

Hawke, L. J., Barr, C. J., McLoughlin, J. V.

Effect of age on treatment outcomes in benign paroxysmal positional vertigo: A systematic review

Bethie Seay — Sun, 14 Nov 2021 06:00:00 +0000

Date Added:

November 14, 2021

Journal/Publication:

Journal of the American Geriatric Society

Publication Date:

October 26, 2021

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

10.1111/jgs.17485

MeSH

Humans

aged

Benign Paroxysmal Positional Vertigo

Outcome Assessment, Health Care

Causality

PubMed

Older patients with benign positional vertigo may need more than one canalith-repositioning procedure to achieve resolution.

View

Background
Benign paroxysmal positional vertigo (BPPV) can lead to an increased fall risk in older adults. Therefore, we examined the influence of age on the effectiveness of canalith-repositioning procedures (CRPs) for the treatment of BPPV.

Methods
Pubmed, Web of Science, and the bibliographies of selected articles were searched for studies conducted before September 2020 that examined the effectiveness of treatments for BPPV in various age groups. Meta-analyses were performed to compare treatment effectiveness and recurrence rates for younger and older adults. Odds ratios were calculated in a random-effects model. Mean differences were calculated using a fixed-effects model. A significance level of p < 0.05 (95% confidence interval) was set. The risk of bias and the methodological quality of all included articles were examined.

Results
Forty-five studies were retrieved after full-text screening, of which 29 studies were included for a qualitative review. The remaining 16 studies were eligible for inclusion in the meta-analysis (3267 participants with BPPV). The success rate of a single CRP was higher in the younger group (72.5% vs. 67%, p < 0.001). An average of 1.4 and 1.5 CRPs was needed for complete recovery in the younger and older groups, respectively (p = 0.02). However, global treatment success did not differ between these groups (97.5% vs. 94.6%, p = 0.41). The recurrence rate was higher in the older population (23.2% vs. 18.6%, p = 0.007).

Conclusions
Although more CRPs are needed, the rate of complete recovery in older adults is similar to that observed in younger adults.

Author/s:

Laurent, G., Vereeck, L., Verbecque, E., Herssens, N., Casters, L., Spildooren, J.

Clinical diagnosis of benign paroxysmal positional vertigo and vestibular neuritis

Carly Hughes — Sat, 16 Jan 2021 20:02:36 +0000

Date Added:

January 16, 2021

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Canadian Medical Association Journal

Publication Date:

February 24, 2020

Issue:

Volume:

192

Pages:

E182-E186

URL:

Clinical diagnosis of benign paroxysmal positional vertigo and vestibular neuritis

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1503/cmaj.190334

Keywords

benign paroxysmal positional vertigo

vestibular neuritis

PMID (1):

32094268

MeSH

Benign Paroxysmal Positional Vertigo

Vestibular Neuronitis

A nice review of how to distinguish BPPV from vestibular neuronitis clinically. James W. Mold, MD, MPH

Free full text

View

Not available

Author/s:

Johns, Peter, Quinn, James

Clinical diagnosis of benign paroxysmal positional vertigo and vestibular neuritis

John Bayhi — Mon, 24 Feb 2020 20:37:12 +0000

Date Added:

February 24, 2020

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Joule Inc

Publication Date:

February 24, 2020

Issue:

Volume:

192

Pages:

E182-E186

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.190334

Keywords

vertigo

benign paroxysmal positional vertigo

MeSH

Benign Paroxysmal Positional Vertigo

A nice review of how to differentiate clinically between benign paroxysmal positional vertigo, vestibular neuritis, and central causes of vertigo.

Free full text

View

KEY POINTS

• Assess patients with vertigo for focal neurologic signs and symptoms, sustained substantial headache or neck pain, inability to stand and spontaneous vertical nystagmus.

• Perform the Dix–Hallpike test only for patients with episodes of vertigo less than 2 minutes and no nystagmus at rest.

• Perform the head impulse, nystagmus and test of skew (HINTS) plus (plus refers to a test of recent hearing loss) examination only for patients with hours or days of constant, ongoing vertigo and nystagmus at rest

Author/s:

Johns, P, Quinn, J