Monitoring of caloric response and outcome in patients with benign paroxysmal positional vertigo.

OBJECTIVE

To analyze the time course of caloric response in patients with Benign Paroxysmal Positional Vertigo (BPPV).

PATIENTS

Seventy-four individuals with diagnosis of BPPV during Dix-Hallpike (DH) test.

STUDY DESIGN

A prospective, longitudinal study.

SETTING

A tertiary referral center.

INTERVENTION

Patients were treated by particle repositioning maneuvers according to the affected canal, and the effectiveness was evaluated at 180 and 360 days. Bithermal caloric response was obtained by using 44 and 30 degrees C water irrigations at diagnosis, 6 months, and 1 year after.

MAIN OUTCOME MEASURE

Canal paresis (CP) and response to DH after treatment.

RESULTS

The effectiveness of the treatment for BPPV (absence of vertigo and positional nystagmus during DH) was 65.2% (45 of 69) after 1 year of follow-up. Twenty-five percent of (16 of 64) individuals with BPPV presented CP at diagnosis, 27% (12 of 44) at 6 months, and 16% (9 of 56) 1 year after. One year after, seven individuals with CP showed a normal caloric response, another seven demonstrated persistent CP, and one case developed a bilateral CP. The effectiveness of particle repositioning maneuvers was not significantly different between subjects with or without CP after 1 year of follow-up (odds ratio, 1.31 [95% confidence intervals, 0.35-4.89], p = 0.88).

CONCLUSION

Canal paresis is not associated with a lower outcome to repositioning.