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Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus

Patients presenting with nystagmus indicative of benign paroxysmal positional vertigo (BPPV) during the left and the right Dix-Hallpike manoeuvres (DHMs) are frequently seen in clinical practice. In such cases, BPPV may be unilateral or bilateral. The aim of this study is to describe the incidence o...

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Autores principales: Domènech-Vadillo, Esther, Álvarez-Morujo De Sande, María Guadalupe, González-Aguado, Rocío, Guerra-Jiménez, Gloria, Galera-Ruiz, Hugo, Ramos-Macías, Antonio, Morales-Angulo, Carmelo, Martín-Mateos, Antonio José, Figuerola-Massana, Enric, Domínguez-Durán, Emilio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini Editore Srl 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256908/
https://www.ncbi.nlm.nih.gov/pubmed/31570901
http://dx.doi.org/10.14639/0392-100X-2214
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author Domènech-Vadillo, Esther
Álvarez-Morujo De Sande, María Guadalupe
González-Aguado, Rocío
Guerra-Jiménez, Gloria
Galera-Ruiz, Hugo
Ramos-Macías, Antonio
Morales-Angulo, Carmelo
Martín-Mateos, Antonio José
Figuerola-Massana, Enric
Domínguez-Durán, Emilio
author_facet Domènech-Vadillo, Esther
Álvarez-Morujo De Sande, María Guadalupe
González-Aguado, Rocío
Guerra-Jiménez, Gloria
Galera-Ruiz, Hugo
Ramos-Macías, Antonio
Morales-Angulo, Carmelo
Martín-Mateos, Antonio José
Figuerola-Massana, Enric
Domínguez-Durán, Emilio
author_sort Domènech-Vadillo, Esther
collection PubMed
description Patients presenting with nystagmus indicative of benign paroxysmal positional vertigo (BPPV) during the left and the right Dix-Hallpike manoeuvres (DHMs) are frequently seen in clinical practice. In such cases, BPPV may be unilateral or bilateral. The aim of this study is to describe the incidence of unilateral and bilateral BPPV when both DHMs are positive, taking into account the sense of the torsional component of nystagmus. This is a prospective multicentre study. BPPV patients were classified into three groups: patients with only one positive DHM (control group, CG), patients showing positive bilateral DHM with nystagmus in the same sense in both DHMs (same sense group, SSG) and patients showing positive bilateral DHM with the torsional component of nystagmus beating in opposite senses in each DHM (opposite sense group, OSG). Only one Epley Manoeuvre (EM) was performed on all patients. Based on the ipsilateral result of the EM, the contralateral result of the same EM and the BPPV resolution rate in the control group, a model was developed to predict the incidence of unilateral and bilateral BPPV in the SSG and the OSG. There were 234 patients in the control group, 20 in the SSG and 23 in the OSG. The model estimated that the percentage of unilateral BPPV would be 89.5% in SSG and 38.7% in OSG. Using these findings, we conclude that when both DHMs are positive, BPPV may be unilateral or bilateral. If the torsional components of both nystagmuses beat in the same sense, it is more likely to be unilateral BPPV. If the torsional components beat in opposite senses, both situations can be considered equally likely.
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spelling pubmed-72569082020-06-08 Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus Domènech-Vadillo, Esther Álvarez-Morujo De Sande, María Guadalupe González-Aguado, Rocío Guerra-Jiménez, Gloria Galera-Ruiz, Hugo Ramos-Macías, Antonio Morales-Angulo, Carmelo Martín-Mateos, Antonio José Figuerola-Massana, Enric Domínguez-Durán, Emilio Acta Otorhinolaryngol Ital Vestibology Patients presenting with nystagmus indicative of benign paroxysmal positional vertigo (BPPV) during the left and the right Dix-Hallpike manoeuvres (DHMs) are frequently seen in clinical practice. In such cases, BPPV may be unilateral or bilateral. The aim of this study is to describe the incidence of unilateral and bilateral BPPV when both DHMs are positive, taking into account the sense of the torsional component of nystagmus. This is a prospective multicentre study. BPPV patients were classified into three groups: patients with only one positive DHM (control group, CG), patients showing positive bilateral DHM with nystagmus in the same sense in both DHMs (same sense group, SSG) and patients showing positive bilateral DHM with the torsional component of nystagmus beating in opposite senses in each DHM (opposite sense group, OSG). Only one Epley Manoeuvre (EM) was performed on all patients. Based on the ipsilateral result of the EM, the contralateral result of the same EM and the BPPV resolution rate in the control group, a model was developed to predict the incidence of unilateral and bilateral BPPV in the SSG and the OSG. There were 234 patients in the control group, 20 in the SSG and 23 in the OSG. The model estimated that the percentage of unilateral BPPV would be 89.5% in SSG and 38.7% in OSG. Using these findings, we conclude that when both DHMs are positive, BPPV may be unilateral or bilateral. If the torsional components of both nystagmuses beat in the same sense, it is more likely to be unilateral BPPV. If the torsional components beat in opposite senses, both situations can be considered equally likely. Pacini Editore Srl 2020-04 2019-09-30 /pmc/articles/PMC7256908/ /pubmed/31570901 http://dx.doi.org/10.14639/0392-100X-2214 Text en Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-Non-Commercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en
spellingShingle Vestibology
Domènech-Vadillo, Esther
Álvarez-Morujo De Sande, María Guadalupe
González-Aguado, Rocío
Guerra-Jiménez, Gloria
Galera-Ruiz, Hugo
Ramos-Macías, Antonio
Morales-Angulo, Carmelo
Martín-Mateos, Antonio José
Figuerola-Massana, Enric
Domínguez-Durán, Emilio
Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title_full Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title_fullStr Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title_full_unstemmed Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title_short Incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right Dix-Hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
title_sort incidence of unilateral and bilateral benign paroxysmal positional vertigo when the left and right dix-hallpike manoeuvres are positive: a model based on the sense of torsional nystagmus
topic Vestibology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256908/
https://www.ncbi.nlm.nih.gov/pubmed/31570901
http://dx.doi.org/10.14639/0392-100X-2214
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