Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Eur Arch Otorhinolaryngol. 2019 Aug;276(8):2181-2189. doi: 10.1007/s00405-019-05459-9. Epub 2019 May 14.
Benign paroxysmal positional vertigo (BPPV) is diagnosed and divided into subtypes based on positioning vertigo and nystagmus. Whether these subtypes entail any significant differences in patient-reported symptoms; is yet not known. Such differences may have clinical and therapeutic consequences. Our aim was to assess dizziness handicap and clinical characteristics of posterior and lateral canal BPPV.
This prospective observational multicentre study analysed consecutive patients with BPPV, confirmed by standardized procedures including videonystagmography under diagnostic manoeuvres in a biaxial rotational chair. Patients were screened for other neurological and otological disorders.
Dizziness handicap inventory (DHI), posterior vs. lateral canal involvement.
age, gender, positional nystagmus intensity (maximum slow-phase velocity), symptom duration, 25-hydroxyvitamin D-level and traumatic aetiology.
132 patients aged 27-90 (mean 57, SD 13) years were included. Higher DHI scores were associated with lateral canal BPPV [95% CI (1.59-13.95), p = 0.01] and female gender [95% CI (0.74-15.52), p = 0.03]. Lateral canal BPPV was associated with longer symptom duration [OR 1.10, CI (1.03-1.17), p = 0.01] and lower 25-hydroxyvitamin D-levels [OR 0.80, CI (0.67-0.95), p = 0.03]. There was no correlation between DHI scores and nystagmus intensity.
This study suggests that patients with lateral canal BPPV have increased patient-perceived disability, lower vitamin D-levels and longer duration of symptoms. This subtype might therefore require closer follow-up. Patient-perceived disability is not related to positional nystagmus intensity.
良性阵发性位置性眩晕（BPPV）根据变位性眩晕和眼震进行诊断和分类。但目前尚不清楚这些亚型是否在患者报告的症状上存在显著差异。这些差异可能具有临床和治疗意义。我们旨在评估后半规管和外半规管 BPPV 的眩晕障碍和临床特征。
这是一项前瞻性观察性多中心研究，分析了通过在双轴转椅上进行诊断性手法的视频眼震图检查确认的 BPPV 连续患者。患者被筛查是否存在其他神经和耳科疾病。
眩晕障碍量表（DHI），后半规管与外半规管受累。
年龄、性别、位置性眼震强度（最大慢相速度）、症状持续时间、25-羟维生素 D 水平和创伤性病因。
本研究表明，外侧半规管 BPPV 患者的患者感知残疾程度更高、维生素 D 水平更低、症状持续时间更长。因此，这种亚型可能需要更密切的随访。患者感知的残疾程度与位置性眼震强度无关。
