The effects of abnormality of cVEMP and oVEMP on rehabilitation outcomes in patients with idiopathic benign paroxysmal positional vertigo

Eur Arch Otorhinolaryngol. 2016 Mar;273(3):643-8. doi: 10.1007/s00405-015-3612-y. Epub 2015 Apr 1.

Abstract

The presence of utricular and saccular dysfunction impairs quality of life (QoL) in patients. The aims of the present study were to examine the effect of repositioning maneuvers on QoL of patients with idiopathic benign paroxysmal positional vertigo (BPPV) and to describe the effect of cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities on patient recovery after rehabilitation. Thirty idiopathic BPPV patients with/without otolith dysfunctions (n = 15, each group) were included in this clinical trial study. Otolith dysfunction was determined using oVEMP and cVEMP abnormalities. EcochG and caloric tests were performed to rule out other causes of secondary BPPV. The QoL in groups of patients with idiopathic BPPV was assessed using a Persian version of the dizziness handicap inventory (DHI-P) before and after treatment with Epley's maneuver. Pre-treatment results showed significant handicaps in both groups. DHI-P scores were higher in BPPV patients with otolith dysfunction (total, functional, emotional, physical score: 34.13, 11.20, 7.06, 15.86, respectively) than those in patients without otolith dysfunction (total, functional, emotional, physical score: 25.46, 7.86, 6.13, 11.46, respectively, P < 0.05). After treatment, DHI-P scores decreased in both groups. However, in the otolith dysfunction group, DHI-P scores (total, functional, emotional, physical score: 9.20, 3.33, 1.33, 4.53, respectively) were higher than those in patients without otolith dysfunction (total, functional, emotional, physical score: 4.13, 0.93, 1.06, 2.00, respectively). In BPPV patients with cVEMP or oVEMP abnormalities, QoL is more compromised in comparison with that in BPPV patients without these dysfunctions. Otolith dysfunction enhances the negative effects of BPPV on QoL.

Keywords: Epley’s maneuver; Handicap; Idiopathic BPPV; Otolith dysfunction.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Benign Paroxysmal Positional Vertigo* / diagnosis
  • Benign Paroxysmal Positional Vertigo* / physiopathology
  • Benign Paroxysmal Positional Vertigo* / psychology
  • Benign Paroxysmal Positional Vertigo* / rehabilitation
  • Caloric Tests / methods
  • Dizziness / physiopathology
  • Dizziness / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Otolithic Membrane / physiopathology*
  • Patient Positioning / methods*
  • Psychological Techniques
  • Quality of Life*
  • Treatment Outcome
  • Vestibular Evoked Myogenic Potentials / physiology*