Inter-frequency amplitude ratio of oVEMP for differentiating Meniere's disease from BPPV: clinical validation using a double-blind approach.

OBJECTIVE: The study aimed at examining the usefulness of inter-frequency amplitude ratio (IFAR) of ocular vestibular evoked myogenic potential (oVEMP) in identifying Meniere's disease (MD) and differentiating it from benign paroxysmal positional vertigo (BPPV). DESIGN: A case-control design was used with a double blind approach. Phase 1 included 70 healthy individuals and 36 individuals each with MD and BPPV and Phase 2 included 20 individuals each with MD and BPPV. The age range of the participants in both phases was 15-50 years. All participants underwent oVEMP testing using 500 and 1000 Hz tone bursts and IFAR was obtained. RESULTS: The results in phase 1 revealed significantly higher IFARs in Meniere's disease than BPPV and healthy individuals (p < 0.001). An optimum criterion point of IFAR ≥1.11 for diagnosing MD was found which yielded 80% sensitivity and 98% specificity. The results in phase 2 demonstrated 85% correct identification of MD and 95% correct rejection of BPPV as non-MD. CONCLUSIONS: IFAR of oVEMP appears highly sensitive and specific parameter for identifying MD and a clinically valid tool for differentiating MD from BPPV.

Prevalence of unrecognized benign paroxysmal positional vertigo in older patients.

Dizziness is a relatively common complaint which occurs more often with increasing age. Benign paroxysmal positional vertigo (BPPV) is an important cause which can easily be treated but is frequently not recognized by professionals. The aim of this study was to assess the prevalence of unrecognized BPPV in older patients. Patients ≥70 years of age (n = 989) indicated whether they experienced dizziness, and if so whether the symptoms were typical for BPPV. If affirmed, a diagnostic maneuver was performed. Positive patients were treated at once. All suspected patients completed quality of life questionnaires and were followed for 3 and 6 months. Positive BPPV patients were compared with negative (but suspected) patients. Almost one quarter of the patients (226 patients, 23 %) suffered from dizziness, among whom 101 were suspected of BPPV. Less than half (n = 45) underwent the diagnostic maneuver, of whom 13 (29 %) were positive for BPPV. At follow-up, one patient developed BPPV, leading to a total of 14 positive patients (overall prevalence 1.4 %). BPPV positive patients did not differ from BPPV negative patients. Among a large group of older patients, one quarter experiences dizziness, and 1.4 % has definite BPPV.

Danhong enhances recovery from residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo.

OBJECTIVES: Although the repositioning maneuvers are usually very effective in patients with BPPV, some patients still complain residual dizziness. Danhong injection (DHI), a traditional Chinese medicine, can effectively dilate blood vessels and improve microcirculation, and has been proven to be effective in improving cervical vertigo and posterior circulation ischemic vertigo. The aim of this study was to evaluate the effects of DHI on residual dizziness after successful repositioning treatment in patients with BPPV. METHODS: Eighty-six patients with BPPV were randomized into two treatment groups, DHI group and non DHI group. The DHI group received the same repositioning treatment as the non-DHI group, with the addition of DHI therapy. The durations of residual dizziness of DHI group and non-DHI group were compared. In addition, the scores of the dizziness handicap inventory of these two groups were calculated. RESULTS: The durations of residual dizziness of DHI group were shorter than that of non-DHI group. There were no significant differences in the scores of dizziness handicap inventory in the first week between these two groups, and there were much significant differences in the second, the fourth, the sixth and eighth weeks. CONCLUSIONS: The results demonstrate that DHI can significantly improve the residual dizziness after successful repositioning treatment in patients with BPPV.