Research in Vestibular Science

Original Article

Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo: Jung-Yup Lee, In-Buhm Lee, Min-Beom Kim; Res Vestib Sci. 2021;20(3):93-100. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.93

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Objectives
This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB).
Methods
A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS＞0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results.
Results
There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (p＜0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation.
Conclusions
We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.

Citations

Citations to this article as recorded by

Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver
Christine C. Little, Zachary G. Schwam, Marc Campo, James Gurley, Bryan Hujsak, Maura K. Cosetti, Jennifer Kelly
Otology & Neurotology Open.2022; 2(3): e014. CrossRef
Gait and Postural Control Characteristics among Individuals with Benign Paroxysmal Positional Vertigo: A Scoping Review
Haziqah Nasruddin, Maria Justine, Haidzir Manaf
Malaysian Journal of Medicine and Health Sciences.2022; 18(s15): 377. CrossRef

Case Report

Rotatory Vertebral Artery Syndrome in Foramen Magnum Stenosis: Ileok Jung, Jin-Man Jung, Moon Ho Park; Res Vestib Sci. 2018;17(4):167-169. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.167

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Abstract PDF

Rotatory vertebral artery syndrome (RVAS) is characterized by recurrent attacks of vertigo, nystagmus, and syncope induced by compression of the vertebral artery during head rotation. A 60-year-old man with atlas vertebrae fracture presented recurrent attacks of positional vertigo. Left-beat, upbeat and count clock-wise torsional nystagmus occurred after lying down and bilateral head roll (HR) showing no latency or fatigue. Magnetic resonance imaging revealed foramen magnum stenosis (FMS) and dominancy of right vertebral artery (VA). The flow of the right VA on transcranial Doppler decreased significantly during left HR. The slower the velocity was, the more the nystagmus was aggravated. RVAS can be evoked by FMS causing compression of the VA. And the nystagmus might be aggravated according to the blood flow insufficiency.

Citations

Citations to this article as recorded by

A Case of Rotational Vertebral Artery Syndrome after Vertebral Artery Dissection
Song Jae Lee, Ha Young Byun, Seung Hwan Lee, Jae Ho Chung
Korean Journal of Otorhinolaryngology-Head and Nec.2020; 63(5): 228. CrossRef

Reviews

Autonomic Dysfunction in Dizziness Clinic: Eun Bin Cho, Ki-Jong Park; Res Vestib Sci. 2018;17(2):37-43. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.37

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Abstract PDF

Orthostatic dizziness is a common type of dizziness. In general, orthostatic dizziness is provoked by standing or tilting, and subsided by supine position. The patient with orthostatic intolerance complains multiple symptoms such as dizziness, palpitation, lightheadness, fatigue and rarely syncope. Common orthostatic intolerance is orthostatic hypotension (classic, initial, transient, and delayed orthostatic hypotension) and postural orthostatic tachycardia syndrome. Transcranial Doppler is a noninvasive technique that provides real-time measurement of cerebral blood flow velocity. It can be useful for understanding the relationship between orthostatic symptoms and cerebral autoregulatory function. The reciprocal causal relationship between vestibular and autonomic dysfunction should always be kept in mind.

Citations

Citations to this article as recorded by

A Study on the Characteristics of Patients Treated for Dizziness with Jeoreongchajeonja-tang: A Retrospective Analysis of 63 Cases
Nu-ri Jung, Ki-tae Kim, Seon-mi Shin, Heung Ko
The Journal of Internal Korean Medicine.2019; 40(6): 1122. CrossRef
Pitfalls in the Diagnosis of Vertigo
Hyun Ah Kim, Hyung Lee
Journal of the Korean Neurological Association.2018; 36(4): 280. CrossRef

Treatment of Neurogenic Orthostatic Hypotension: Jung-Ick Byun, Sang Beom Kim; Res Vestib Sci. 2017;16(3):73-79. Published online September 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.3.73

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Abstract PDF

Orthostatic hypotension (OH) is a common feature of sympathetic autonomic dysfunction and can lead to lightheadedness, weakness, dizziness, and syncope. It is defined as decrease in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg within 3 minutes of standing. OH is associated with an increased incidence of cerebrovascular disease, myocardial infarction, and mortality. Non-pharmacological treatments may alleviate OH-related symptoms; however, are not sufficient when used alone. Pharmacological treatment is essential in managing OH. In this review, we aimed to discuss non-pharmacological and pharmacological treatment options for OH.

Citations

Citations to this article as recorded by

Classification of Chronic Dizziness in Elderly People and Relation with Falls
Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park
Research in Vestibular Science.2018; 17(1): 13. CrossRef

Original Article

The Influence of Sleep Position on Benign Paroxysmal Positional Vertigo: Yong Gook Shin, Jin Woo Park, Ja Won Gu, Mee Hyun Song, Dae Bo Shim; Res Vestib Sci. 2016;15(4):121-125. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.121

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Abstract PDF: Objective: The purpose of this study was to identify the influence of sleep position on benign paroxysmal positional vertigo (BPPV).
Methods
Four hundred sixty patients diagnosed as posterior or horizontal canal BPPV were analyzed retrospectively. All patients were asked about their preferred sleep positions among the following four choices: supine, right or left lateral, or no predominant side via questionnaire at initial visit and after 1month. Patients were classified into two groups: affected side group meaning that the patient preferred to sleep ipsilateral to the affected ear and other position group including all positions other than lying lateral to the affected side after treatment. We analyzed the change in the sleep pattern after treatment and compared the recurrence rate between the two groups.
Results
Our study included 244 patients with posterior canal BPPV (PC-BPPV) and 216 patients with horizontal canal BPPV (HC-BPPV). Statistically significant correlation was demonstrated between sleep position side and the affected side by BPPV. The number of patients who slept on the affected side by BPPV decreased, while the number of patients who slept on the healthy side increased significantly after treatment. There was no statistically significant difference in the recurrence rate between the two groups.
Conclusion
There was significant correlation between the sleep position side and the affected side in PC-BPPV and HC-BPPV. The patient had a tendency to avoid lying lateral to the affected side by BPPV during sleep after treatment, however the change in sleep position did not influence the recurrence rate of BPPV.

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