Cargando…

Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo

BACKGROUND: Utricular degeneration is the source of traveling otoconia inside the semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). The underlying pathology is not clear. The aim of this study was to analyze vestibulo-ocular reflex (VOR) during sudden head acceleratio...

Descripción completa

Detalles Bibliográficos
Autores principales: Yetiser, Sertac, Ince, Dilay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935628/
https://www.ncbi.nlm.nih.gov/pubmed/33747325
http://dx.doi.org/10.14740/jocmr4413
_version_ 1783661039790850048
author Yetiser, Sertac
Ince, Dilay
author_facet Yetiser, Sertac
Ince, Dilay
author_sort Yetiser, Sertac
collection PubMed
description BACKGROUND: Utricular degeneration is the source of traveling otoconia inside the semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). The underlying pathology is not clear. The aim of this study was to analyze vestibulo-ocular reflex (VOR) during sudden head accelerations in those patients since clinical reports designating an association of BPPV with inner ear problems are increasing. METHODS: VOR reaction to impulsive head rotations were tested in 34 patients with BPPV (13 lateral, 21 posterior canal BPPV) and 15 healthy subjects in a prospective controlled study. Main outcome measure was the gain (the ratio of head and eye velocity) of vertical and horizontal head auto-rotations to the pathologic and normal sides. RESULTS: All patients with BPPV and control subjects had normal gain (≥ 0.9) at 1 and 2 Hz but the gain decreased at higher frequencies. No statistically significant difference was found when comparing the gain between the horizontal head rotations toward the pathologic and those toward the normal side (P = 0.89, P = 0.90, P = 0.78, P = 0.20 and P = 0.16, at 1, 2, 3, 4 and 5 Hz, respectively) and between upward and downward vertical head rotations (P = 0.28, P = 0.53 and P = 0.15, at 1, 2 and 3 Hz, respectively) in patients with lateral and posterior canal BPPV. CONCLUSION: VOR gain was reduced in some patients. However, head auto-rotation test (HART) does not show any functional abnormality of VOR during head rotations toward the pathologic side. HART is not suitable as a screening test for BPPV.
format Online
Article
Text
id pubmed-7935628
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elmer Press
record_format MEDLINE/PubMed
spelling pubmed-79356282021-03-18 Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo Yetiser, Sertac Ince, Dilay J Clin Med Res Original Article BACKGROUND: Utricular degeneration is the source of traveling otoconia inside the semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). The underlying pathology is not clear. The aim of this study was to analyze vestibulo-ocular reflex (VOR) during sudden head accelerations in those patients since clinical reports designating an association of BPPV with inner ear problems are increasing. METHODS: VOR reaction to impulsive head rotations were tested in 34 patients with BPPV (13 lateral, 21 posterior canal BPPV) and 15 healthy subjects in a prospective controlled study. Main outcome measure was the gain (the ratio of head and eye velocity) of vertical and horizontal head auto-rotations to the pathologic and normal sides. RESULTS: All patients with BPPV and control subjects had normal gain (≥ 0.9) at 1 and 2 Hz but the gain decreased at higher frequencies. No statistically significant difference was found when comparing the gain between the horizontal head rotations toward the pathologic and those toward the normal side (P = 0.89, P = 0.90, P = 0.78, P = 0.20 and P = 0.16, at 1, 2, 3, 4 and 5 Hz, respectively) and between upward and downward vertical head rotations (P = 0.28, P = 0.53 and P = 0.15, at 1, 2 and 3 Hz, respectively) in patients with lateral and posterior canal BPPV. CONCLUSION: VOR gain was reduced in some patients. However, head auto-rotation test (HART) does not show any functional abnormality of VOR during head rotations toward the pathologic side. HART is not suitable as a screening test for BPPV. Elmer Press 2021-02 2021-02-25 /pmc/articles/PMC7935628/ /pubmed/33747325 http://dx.doi.org/10.14740/jocmr4413 Text en Copyright 2021, Yetiser et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yetiser, Sertac
Ince, Dilay
Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title_full Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title_fullStr Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title_full_unstemmed Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title_short Active Head Auto-Rotations in Patients With Benign Paroxysmal Positional Vertigo
title_sort active head auto-rotations in patients with benign paroxysmal positional vertigo
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935628/
https://www.ncbi.nlm.nih.gov/pubmed/33747325
http://dx.doi.org/10.14740/jocmr4413
work_keys_str_mv AT yetisersertac activeheadautorotationsinpatientswithbenignparoxysmalpositionalvertigo
AT incedilay activeheadautorotationsinpatientswithbenignparoxysmalpositionalvertigo