Dizziness handicap and clinical characteristics of posterior and lateral canal BPPV
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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. Factors: 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.
KeywordsLateral canal BPPV Posterior canal BPPV Videonystagmography Biaxial rotational chair Quality of life
Thanks to the employees at the department of Otorhinolaryngology, Head and Neck Surgery, Haukeland, Bergen who have been helping me with the logistics. Special thanks to my cherished colleague Elisabeth Torkildsen, for her invaluable help with managing the collection and registration of data, and to Rolf Gjestad for his support of great value in data analysis.
The authors have no funding and relationships.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to disclose.
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