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Multicenter Study on the Clinician’s Diagnostic and Therapeutic Approaches for Benign Paroxysmal Positional Vertigo in Korea
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Eun Ju Jeon, Won Ho Chung, Jeong Hwan Choi, Eui Cheol Nam, Hong Ju Park, Jong Dae Lee, Won Sang Lee, Kyu Sung Kim, Eui Kyung Goh, Ja Won Koo, Min Bum Kim, Min Beom Kim, Se Hyung Kim, Young Jin Kim, Chang Hee Kim, Sung Il Nam, Seog Kyun Mun, Ga Young Park, Sang Yoo Park, Shi Nae Park, Chang Hoon Bae, Sung Hyun Boo, Myung Whan Suh, Jae Hyun Seo, Eun Jin Son, Jae Jun Song, Jae Jin Song, Joong Wook Shin, Dae Bo Shim, Seong Ki Ahn, Hye Youn Youm, Shin Young Yoo, Dong Hee Lee, Seung Hwan Lee, Chang Ho Lee, Hyun Seok Lee, Hwan Ho Lee, Hyo Jeong Lee, Yun Hoon Choung, Seung Hyo Choi, Jee Sun Choi, Seok Min Hong, Sung Kwang Hong
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Res Vestib Sci. 2013;12(3):79-92.
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 Abstract
- Background and Objectives: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician’s diagnostic and therapeutic approaches for BPPV. Materials and Methods: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. Results: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). Conclusion: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.
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Clinical Review of Dizziness Patients Who Visited Emergency Room
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Ki Yong Kim, Hyun Jung Min, Seung Hwan Lee, Chul Won Park
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Res Vestib Sci. 2011;10(2):56-62.
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Abstract
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- Background and Objectives: As most dizziness symptoms are vaigue, and misdiagnosis of central dizziness can be life threatening, diagnosis of the dizziness is difficult. Especially, in the emergency room with a restricted environment, it must be more difficult. The aim of this study is to find out and correct the aspects requiring a modification for diagnosis in patients of dizziness who visited emergency room. Materials and Methods: The authors retrospectively have reviewed the charts of 458 patients with dizziness who visited the emergency room at Hanyang University Guri Hospital from April 2008 to March 2009 and researched the various informations such as diagnosis, clinical feature, physical findings, present illness, past history, consulted department, and visiting season, etc. Results: The average age of patients was 61 years old. Even though there was a difference at the diagnosis distribution between age groups, non specific dizziness and benign paroxysmal positional vertigo was the most frequent diagnosis. Checking the dizziness characters like whirling sense, autonomic symptoms and progressing features was important. And vestibular function tests such as nystagmus test and rotatory test like post head shaking or head thrust test were helpful for differential diagnosis of dizziness in emergency room. Patients with central vertigo were older (71.2 year) and had more past medical histories. But there was no seasonal frequency difference of dizziness.Conclusion: As at emergency room, the differential diagnosis of dizziness is important but difficult, integrated medical knowledge of several departments associated with dizziness is required.
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