[The characteristics of benign paroxysmal positional vertigo and application of Epley's maneuver in very old patients].

ABSTRACT

OBJECTIVE: To analyze the characteristics of benign paroxysmal positional vertigo (BPPV) and the efficacy and safety of Epley's maneuver in very old patients. METHODS: A retrospective review of 29 (16.5%) patients with BPPV out of 176 consecutively admitted patients aged 80 and over presented with a complaint of dizziness was performed. RESULTS: In all 29 patients the BPPV origin was attributed to posterior canal involvement; 24 (82.8%) were idiopathic, 4 with a history of Ménière's disease, and 1 secondary to head trauma; 18 (62.1%) were right-side involved; and 25 (86.2%) were diagnosed previously as vertebral-basilar insufficiency. Cardio- and cerebrovascular diseases and the correlative risk factors were common both in patients with BPPV and those with non-BPPV dizziness. Twenty-one patients underwent Epley's maneuver, all were free of vertigo after treatment, 14 of them after a single session and the remaining 2 to 4 sessions. No significant complications were observed except in one who experienced vomiting during the procedure. Patients who received Epley's maneuver had a higher cure rate and short recovery time than those who did not. CONCLUSIONS: BPPV is not uncommon in very old patients with dizziness. Clinicians should have the knowledge to diagnose and treat this condition. Epley's maneuver is safe and effective in very old patients with BPPV.