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Otorinolaringologia 2007 June;57(2):41-9

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

The etiological factors and therapy for benign paroxysmal positional vertigo: evaluation of therapeutical possibilities

Skutil J., Novotný M., Kostřica R.

1 HNO Clinic, Städtisches Klinikum Dessau Akademisches Lehrkrankenhaus der Martin Luther Universität Halle, Wittenberg, Germany 2 ENT Clinic, St.Anna’s Hospital, Brno, Czech Republic


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Aim. Benign paroxysmal positional vertigo (BPPV) has been considered a separate nosological entity. BPPV was described for the first time by Adler in 1887. The clinical picture is characterised by a sudden development of acute vertigo following a swift head movement appearing after 10 s and disappearing 1 min later. The state is accompanied by striking vegetative symptomatology and positional nystagmus. This problem is explained by theories of canalolithiasis and cupulolithiasis.
Methods. Within 2001-2003 we treated 66 patients with BPPV who underwent complex neuro-otological investigations. The set involved 20 (30%) male and 46 (70%) female patients. In the history we asked about the occurrence of inflammatory, traumatic and algic, and metabolic etiological factors. After diagnosing BPPV, the therapy was performed by means of rehabilitation exercises according to Sèmont and Epley.
Results. Our study concluded that the most frequent etiological factors were: upper respiratory diseases in 44%, acute otitis media in 29% and trauma in 21% cases. In accordance with literature we have found the same incidence of trauma (21%), and chronic otitis media (1.5%) as etiological factors of BPPV.
Conclusion. On the basis of our findings, upper respiratory diseases, acute otitis media, diabetes mellitus, allergy and cholecystolithiasis may be considered etiological factors in BPPV. The therapy is based on special rehabilitation manoeuvres which are clinically and finantially very effective. According to literature, the therapeutical success of rehabilitation manoeuvres is 80-90%. In our group Sèmont´s manoeuvre was effective in 88% cases, Epley´s manoeuvre in 91% cases.

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