Disease relevance of BPPV

• We report a patient with neurosarcoidosis who developed bilateral benign paroxysmal positional vertigo (BPPV) of the posterior canals, deafness, and absent responses to conventional caloric and rotational vestibular testing [1].
• We compared the effects on breathing and speech production of assist-control ventilation (ACV) and bilevel positive-pressure ventilation (BPPV) in nine patients with neuromuscular disease [2].
• METHODS: CEMP was examined in 40 patients with acute vertigo of vestibular origin (26 with acute peripheral vestibulopathy, five with Ménière's disease, three with benign paroxysmal positioning vertigo (BPPV), six with psychogenic vertigo) and the results compared with standard caloric reaction (CR) [3].
• RESULTS: Patients with BPPV (35.3%) and with vestibular neuritis (52.2%) had pathological test values on caloric irrigation (p<0.001) [4].
• Benign paroxysmal positional vertigo (BPPV) and Ménière's disease (MD) are statistically related to migraine, but the possible pathogenetic links have not been established [5].

Psychiatry related information on BPPV

• METHODS: Participants were divided into eight diagnostic groups: healthy volunteers (n=26) and patients with benign paroxysmal positioning vertigo (BPPV, n=11), vestibular neuritis (n=11), Menière's disease (n=7), vestibular migraine (n=15), anxiety (n=23), depression (n=12), or somatoform disorders (n=22) [4].
• OBJECTIVE: To evaluate the effect of cigarette and alcohol consumption on BPPV [6].
• CONCLUSION: Psychological factors play an important role in patients with BPPV [7].
• CONCLUSIONS: Within the poorly understood mechanisms implicated in the aetiology of benign paroxysmal positional vertigo (BPPV), the results of this trial provide clinical evidence of a potential role of emotional stress connected to adverse life events as a trigger of otoconial dysfunction [8].
• RESULTS: The psychological variables tested, namely, loneliness, depression, anxiety components, introversion, and social desirability, were found to be statistically significant (p < .01) for the three groups (i.e., BPPV, psychogenic, and control) [7].

High impact information on BPPV

• We compared the efficacy of a modified Epley's procedure (MEP) and Brandt-Daroff exercises (BDE) for self-treatment of benign paroxysmal positional vertigo of the posterior semicircular canal (PC-BPPV) in 54 patients [9].
• Nevertheless, despite their important contributions, neither Bárány nor Dix and Hallpike understood the pathophysiology of BPPV nor did they appreciate that the positioning techniques they used actually demonstrated pathology in the semicircular canals rather than the utricle [10].
• CONCLUSION: It is argued that some patients with idiopathic pDBN have benign paroxysmal positional vertigo (BPPV) with lithiasis of the anterior canal [11].
• AIM: To compare patients with BPPV referred initially to a Falls and Syncope Unit (FSS group) with those initially referred to a Regional ENT/Balance Service (ENT group) [12].
• First, the abnormal stimulus being applied to the vestibular system during BPPV episodes is estimated by an analysis of the vestibulo-ocular reflex (VOR) response of clinical BPPV patients [13].

Chemical compound and disease context of BPPV

• OBJECTIVES: To analyze the incidence and characteristics of benign paroxysmal positional vertigo (BPPV) in patients with Ménière's disease who did not respond to medical treatment and to whom intratympanic gentamycin treatment was proposed [14].
• Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the vestibular system in which calcite particles called otoconia interfere with the mechanical functioning of the fluid-filled semicircular canals normally used to sense rotation [15].

Biological context of BPPV

• The atypical ageotropic paroxysmal positional nystagmus of the posterior semicircular canal was observed in the evolution of the BPPV in 2 patients and on the first examination in the third [16].
• Especially, the similarity index tended to reflect the clinical course of the vestibular compensation and the findings in the patients with benign paroxysmal positional vertigo (BPPV) demonstrated that its vestibular function may include various pathologies besides canalithiasis [17].
• In BPPV, the torsional component of eye movements was larger than that of the vertical component without obvious horizontal eye deviation [18].
• In the patient with bilateral BPPV, no change of the pulse rate was observed after rotation toward the right or to the left posterior canal [19].
• We compared the results obtained by Prolonged Position with two other physical therapies by dividing our horizontal canal BPPV patients into three therapeutic groups: 1) 35 patients treated with Prolonged Position; 2) 24 patients treated with head shaking in a supine position; 3) 15 patients for whom therapy was omitted [20].

Anatomical context of BPPV

• The modern understanding of the pathophysiology of BPPV began with Schuknecht's proposal that the dysfunction resulted from the gravity-dependent movement of loose or fixed dense material within the posterior semicircular canal ("cupulolithiasis") [10].
• All patients presented with intractable BPPV that did not respond completely to otolith repositioning procedures [21].
• Additionally, 70 archived temporal bones without a history of BPPV were examined microscopically for the presence of particulate matter within the lumen of the membranous labyrinth [22].
• The recent demonstration of free-floating particles in the endolymph of the posterior semicircular canal in patients with benign paroxysmal positional vertigo (BPPV) has renewed interest in the physiology and treatment of this entity [23].
• This difference was not significant (chi = 0.17, P =.68) CONCLUSION: For the treatment of posterior canal BPPV, concurrent mastoid oscillation with CRP does not significantly alter the short-term outcome [24].

Associations of BPPV with chemical compounds

• Twelve consecutive patients with intractable BPPV underwent PCO by three surgeons, six with mechanical PCO and six with CO2 laser-assisted PCO [25].
• RESULTS: Control subjects smoked significantly more often than BPPV patients, and patients without recurrence more frequently than patients with recurrence [6].

Other interactions of BPPV

• Recently, we reviewed our four-year experience with new onset vertigo in our university-based MS population and found that benign paroxysmal positioning vertigo (BPPV) to be the most common cause [26].
• METHODS: A retrospective chart review of 107 patients diagnosed with BPPV at our institution between March of 1993 and June of 1995 [27].
• We describe two patients with intractable BPPV and profound sensorineural hearing loss in the affected ear treated by transmastoid posterior semicircular canal occlusion [28].
• This paper presents a combined procedure for the management of intractable benign paroxysmal positional vertigo (BPPV) and profound hearing loss in a patient with far advanced otosclerosis [29].

Analytical, diagnostic and therapeutic context of BPPV

• Speech induced an increase in inspiratory time during BPPV, with a greater increase in the volume released by the ventilator during speech as compared with ACV (172 +/- 194 versus 26 +/- 31 ml) [2].
• BPPV is suggested by history, readily diagnosed by office examination, and cured by appropriate exercise therapy [30].
• OBJECTIVES--To review the clinical features, electronystagmography findings, the possible mechanism, and a possible therapeutic approach to benign paroxysmal positional vertigo (BPPV) [31].
• In two cases, BPPV occurred when patients moved their head while maintaining strict bedrest [32].
• An Internet survey of the relevant literature in English shows a scarcity of publications on the incidence of BPPV following stapedectomy [33].

References