CLINICAL EVALUATION OF POSITIONAL VERTIGO

Abstract

Praveen N1, Swathilal S. A2

BACKGROUND
Vertigo is a very common symptom with which patients see a doctor in clinical practice. It is defined as “subjective sense of imbalance”. Vertigo can be broadly classified into Subjective and Objective types. Each can be again divided into episodic lasting for seconds or hours and prolonged lasting for weeks. A common presenting form of vertigo is that which is experienced when the patient turns his head in a particular position i.e. the positional vertigo, in some cases the vertiginous symptoms are also accompanied by a positional nystagmus. Benign Paroxysmal Positional Vertigo (BPPV) is one the most common causes of vertigo. In the present study 100 patients were evaluated for Positional Vertigo.
The aim of the study is to analyse patients presenting with positional vertigo and to evaluate the Effectiveness of Epley’s manoeuvre in BPPV and Medical management in patients with negative Dix Hallpike’s Positional test.
MATERIALS AND METHODS
The study included 100 consecutive patients diagnosed with positional vertigo. A detailed history and general examination and ENT examination was done including vestibular function evaluation. X-Ray cervical spine, P T A and caloric test (cold) were done. CT scan and MRI performed. Positional test positive patients were treated with Epley’s manoeuvre and results analysed.
RESULTS
100 patients with positional vertigo and among them 70 with BPPV were included in the present study. The mean age of the patient’s was 42.34±4.6 years. 30% of the patients belonged to the age group of 51 to 60 years, 25% to the age group of 41 to 50 years, and 20% to the age group of 31 to 40 years. 70/100 patients were treated with Epley’s manoeuvre. The response to Epley’s manoeuvre in the study showed that 65 patients were symptom free after 2 weeks, 67 after 1 month and 69 after 3 to 6 months period.
CONCLUSION
BPPV is one of the major causes of Positional Vertigo and that it could be very effectively treated using Epley’s manoeuvre. Labyrinthine Sedatives, Vasodilators and Neurotropic vitamins have some role in controlling symptoms in patients with Positional Vertigo.
KEYWORDS
Vertigo, Positional Vertigo, Epley Manoeuvre, BPPV, Nystagmus, Labyrinthine Sedatives.

image