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Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo

  • Jose A. Lopez-Escamez
  • Maria J. Gamiz
  • Antonio Fernandez-Perez
  • Manuel Gomez-Fiñana
Miscellaneous

Abstract

A prospective cohort study was designed to evaluate the long-term outcome and health-related quality of life (HRQoL) in patients with posterior canal benign paroxysmal positional vertigo (PC-BPPV) treated by the particle repositioning maneuver (PRM) in the outpatient clinic of a general community hospital. Fifty individuals with PC-BPPV were included, and 45 (90%) completed the study. The diagnosis was based on the history of short episodes of vertigo and a positional nystagmus during the Dix-Hallpike test (DHT). All patients were treated by a single PRM, and relapses were evaluated by DHT at 30, 180 and 360 days post-treatment; a new PRM was performed if the DHT was positive. The main outcome measures were: percentage of patients with a negative DHT after treatment, scores obtained on the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Dizziness Handicap Inventory Short Form (DHI-S) before and 30, 180 and 360 days post-treatment. The DHT was found negative in 80% (40/50) of individuals at 30 days. Ten, seven and five patients presented a positive DHT at 30, 180 and 360 days, respectively. Persistent BPPV was observed in 5% (2/50) of patients at 360 days, despite repeated PRM. Relapses (DH+ after successful PRM) were observed in 7.5% (3/50) at 180 days and 360 days. Both questionnaires showed a reliability Cronbach’s alpha >0.7. The average standardized score for each SF-36 scale was compared with the reference population normative data, showing differences with norms for all scales except for vitality. After PRM, patients improved their scores with both instruments, indicating a restoration of HRQoL at 30 days. Physical dimension scores of the SF-36 improved from day 30 to 360. DHI-S scores were statistically better after PRM (P<0.001). Our results show that the effectiveness of PRM is 88% after 1 year of follow-up. Patients with BPPV experienced a decrease in HRQoL, which was restored after PRM. Although relapses were observed in 7.5% of individuals, they did not affect HRQoL.

Keywords

BPPV Vestibular habituation Vestibular training 

Notes

Acknowledgements

This study was funded by Research Project 132/00 from the Consejeria de Salud, Junta de Andalucia and the FIS PI021394 Project, Spain. We acknowledge Dr. Jordi Alonso from the International Quality of Life Assessment (IQOLA) project for providing us with the Spanish version of the SF-36 Health Survey.

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Jose A. Lopez-Escamez
    • 1
  • Maria J. Gamiz
    • 1
  • Antonio Fernandez-Perez
    • 1
  • Manuel Gomez-Fiñana
    • 1
  1. 1.Otology and Neurotology Group CTS495 of the Department of SurgeryHospital de PonienteAlmeríaSpain

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