Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2013
Autonomic dysfunction as a possible cause of residual dizziness after successful treatment in benign paroxysmal positional vertigo.
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Kim Hyun-Ah, Lee Hyung
Аннотация
OBJECTIVE: To investigate whether residual dizziness after successful treatment in patients with benign paroxysmal positional vertigo (BPPV) was associated with autonomic dysfunction.
METHODS: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures (CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and divided into two groups with and without residual dizziness. We performed a standardized autonomic function test.
RESULTS: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the next follow-up than those without residual dizziness (40% and 3%, p=0.000). Compared to patients without residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different between the patients with and without residual dizziness.
CONCLUSION: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural autonomic dysfunction.
SIGNIFICANCE: This investigation could be useful in understanding the mechanism of residual dizziness in patients with BPPV.
METHODS: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures (CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and divided into two groups with and without residual dizziness. We performed a standardized autonomic function test.
RESULTS: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the next follow-up than those without residual dizziness (40% and 3%, p=0.000). Compared to patients without residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different between the patients with and without residual dizziness.
CONCLUSION: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural autonomic dysfunction.
SIGNIFICANCE: This investigation could be useful in understanding the mechanism of residual dizziness in patients with BPPV.