Conduct after Epley's maneuver in elderly with posterior canal BPPV in the posterior canal.

UNLABELLED: Benign Paroxysmal Positional Vertigo is the most common peripheral vestibular disorder, especially in the elderly and presents as the predominant etiology in this population of the degeneration of the utricular macula. AIM: To compare the effectiveness of the approaches after Epley maneuver. STUDY DESIGN: longitudinal cohort. MATERIALS AND METHODS: The study included 53 volunteers with Benign Paroxysmal Positional Vertigo of the posterior semicircular canal, divided into Group 1, who underwent Epley maneuver associated with the use of neck collar and post-maneuver instructions, Group 2 underwent the Epley maneuver without the use cervical collar and/or post-maneuver restrictions, and Group 3 underwent the Epley maneuver associated with the use of a mini vibrator, without the use of neck collar and/or post-maneuver restrictions. RESULTS: In the three groups, the number of Epley maneuvers ranged from one to three. We employed the Brazilian Dizziness Handicap Inventory - pre-and post-treatment and observed a statistically significant difference on most scores pre-and post-treatment for both groups. CONCLUSION: Regardless of the post Epley maneuver treatment selected for the treatment of Benign Paroxysmal Positional Vertigo, it was effective when comparing the Brazilian Dizziness Handicap Inventory pre-and post-treatment.

Condutas pós-manobra de Epley em idosos com VPPB de canal posterior / Conduct after Epley's maneuver in elderly with posterior canal BPPV in the posterior canal

Benign Paroxysmal Positional Vertigo is the most common peripheral vestibular disorder, especially in the elderly and presents as the predominant etiology in this population of the degeneration of the utricular macula. AIM: To compare the effectiveness of the approaches after Epley maneuver. Study Design: longitudinal cohort. MATERIALS AND METHODS: The study included 53 volunteers with Benign Paroxysmal Positional Vertigo of the posterior semicircular canal, divided into Group 1, who underwent Epley maneuver associated with the use of neck collar and post-maneuver instructions, Group 2 underwent the Epley maneuver without the use cervical collar and/or post-maneuver restrictions, and Group 3 underwent the Epley maneuver associated with the use of a mini vibrator, without the use of neck collar and/or post-maneuver restrictions. RESULTS: In the three groups, the number of Epley maneuvers ranged from one to three. We employed the Brazilian Dizziness Handicap Inventory - pre-and post-treatment and observed a statistically significant difference on most scores pre-and post-treatment for both groups. CONCLUSION: Regardless of the post Epley maneuver treatment selected for the treatment of Benign Paroxysmal Positional Vertigo, it was effective when comparing the Brazilian Dizziness Handicap Inventory pre-and post-treatment.

A Vertigem Postural Paroxística Benigna é a mais comum das vestibulopatias periféricas, principalmente em idosos e apresenta como etiologia predominante nessa população à degeneração da mácula utricular. OBJETIVO: Comparar a eficácia das condutas pós-manobra de Epley. Desenho do Estudo: Estudo de coorte contemporâneo longitudinal. MATERIAL E MÉTODO: Participaram do estudo 53 voluntários com Vertigem Postural Paroxística Benigna de canal semicircular posterior, distribuídos em Grupo 1, submetidos à manobra de Epley associada ao uso do colar cervical e orientações pós-manobra; Grupo 2 submetido a manobra de Epley sem uso do colar cervical e/ou restrições pós-manobra, e Grupo 3 submetido à manobra de Epley associada com o uso de um minivibrador, sem uso de colar cervical e/ou restrições pós-manobra. RESULTADOS: Nos três grupos, o número de manobras de Epley variou de uma a três. Aplicou-se o Dizziness Handicap Inventory brasileiro pré e pós-tratamento e observou-se diferença estatisticamente significativa na maioria dos escores pré e pós-tratamento para os grupos avaliados. CONCLUSÃO: Independentemente da conduta pós-manobra de Epley selecionada para o tratamento da Vertigem Postural Paroxística Benigna, essa se mostrou eficaz quando se comparou o Dizziness Handicap Inventory brasileiro pré e pós-tratamento.

Number of maneuvers need to get a negative Dix-Hallpike test.

UNLABELLED: Benign Paroxysmal Positional Vertigo is one of the most common causes of dizziness. Its characteristic clinical profile is dizziness at head movements. The main diagnostic maneuver of posterior canal Benign Paroxysmal Positional Vertigo is the Dix-Hallpike test. If the maneuver is positive (vertigo and/or nystagmus), the physician can perform the Epley maneuver on the injured side. AIM: This paper aims at checking the number of maneuvers necessary for patients with posterior canal Benign Paroxysmal Positional Vertigo to have a negative Dix-Hallpike test. MATERIALS AND METHODS: we carried out a retrospective analysis of 71 charts of patients with posterior canal Benign Paroxysmal Positional Vertigo, who were treated with the modified Epley maneuver. STUDY DESIGN: Cross-Sectional Retrospective. RESULTS: We found that 76.00% of the patients analyzed had the symptoms completely resolved and negative Dix-Hallpike test with a single maneuver. CONCLUSION: Based on our results it is possible to conclude that the number of modified Epley maneuvers is variable depending on the etiology, being that the Benign Paroxysmal Positional Vertigo secondary to the traumatic brain injury needed a greater number of maneuvers for Dix-Hallpike test to become negative.

Number of maneuvers need to get a negative Dix-Hallpike test / Número de manobras necessárias para a negativação do teste de Dix-Hallpike

Benign Paroxysmal Positional Vertigo is one of the most common causes of dizziness. Its characteristic clinical profile is dizziness at head movements. The main diagnostic maneuver of posterior canal Benign Paroxysmal Positional Vertigo is the Dix-Hallpike test. If the maneuver is positive (vertigo and/or nystagmus), the physician can perform the Epley maneuver on the injured side. AIM: This paper aims at checking the number of maneuvers necessary for patients with posterior canal Benign Paroxysmal Positional Vertigo to have a negative Dix-Hallpike test. MATERIALS AND METHODS: we carried out a retrospective analysis of 71 charts of patients with posterior canal Benign Paroxysmal Positional Vertigo, who were treated with the modified Epley maneuver. STUDY DESIGN: Cross-Sectional Retrospective. RESULTS: We found that 76.00 percent of the patients analyzed had the symptoms completely resolved and negative Dix-Hallpike test with a single maneuver. CONCLUSION: Based on our results it is possible to conclude that the number of modified Epley maneuvers is variable depending on the etiology, being that the Benign Paroxysmal Positional Vertigo secondary to the traumatic brain injury needed a greater number of maneuvers for Dix-Hallpike test to become negative.

A Vertigem Postural Paroxística Benigna é uma das causas mais comuns de tontura. Seu quadro clínico característico é tontura ao movimentar a cabeça. A principal manobra diagnóstica da Vertigem Postural Paroxística Benigna de canal posterior é o teste de Dix-Hallpike. Se a manobra for positiva (presença de vertigem e/ou nistagmo), indica-se realizar a manobra de reposicionamento de Epley do lado acometido OBJETIVO: Este trabalho tem como objetivo verificar o número de manobras necessárias para a negativação do teste de Dix-Hallpike em pacientes com Vertigem Postural Paroxística Benigna de canal posterior. MATERIAL E MÉTODO: Foi realizado uma análise retrospectiva de 71 prontuários de pacientes com Vertigem Postural Paroxística Benigna de canal posterior, os quais foram tratados com a manobra modificada de Epley. FORMA DE ESTUDO: Retrospectivo Transversal. RESULTADOS: Foi observado que 76,00 por cento dos pacientes analisados tiveram resolução completa dos sintomas e negativação do teste de Dix-Hallpike com apenas uma manobra. CONCLUSÃO: Diante destes resultados, podemos concluir que o número de manobras modificadas de Epley é variável de acordo com a etiologia, sendo que a Vertigem Postural Paroxística Benigna secundária ao traumatismo cranioencefálico necessitou de maior número de manobras para a negativação do teste de Dix-Hallpike.

Audiologic features of elderly with Benign Paroxysmal Positional Vertigo.

UNLABELLED: Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness; it constitutes the most common vestibular disorder in the elderly with vertigo. Its characteristic clinical aspect is dizziness at head movement, with not hearing alteration. AIM: This paper aims at studying the audiologic characteristics of elderly with BPPV of the posterior semicircular canal. MATERIALS AND METHODS: We carried out a retrospective analysis of threshold tonal audiometry exams of 37 senior citizens with posterior semicircular canal BPPV and also of 37 elderly without complaints of dizziness and/or vertigo, and we studied the audiologic characteristics of the two groups. RESULTS: Both groups had high rates of hearing loss, especially the descending curve sensorineural type, and there was no statistically significant difference between the groups. CONCLUSION: Having such data, we can conclude that posterior semicircular canal BPPV has no impact on the hearing loss features of senior citizens; nonetheless, because of the spontaneous degeneration of the vestibulocochlear system, such population has a prevalence of hearing loss.

Características audiológicas de idosos com Vertigem Posicional Paroxística Benigna / Audiologic features of elderly with Benign Paroxysmal Positional Vertigo

A Vertigem Posicional Paroxística Benigna (VPPB) é uma das causas mais comuns de tontura, sendo a desordem vestibular mais comum em idosos vertiginosos. Seu quadro clínico característico é tontura ao movimentar a cabeça, com ausência de alterações auditivas. OBJETIVO: Este trabalho tem como objetivo verificar as características audiológicas de idosos com VPPB de canal posterior. MATERIAL E MÉTODO: Foi realizada uma análise retrospectiva de exames de audiometria tonal limiar de 37 idosos com VPPB de canal posterior e de 37 idosos sem nenhuma queixa de tontura e/ou vertigem, sendo observadas as características audiológicas dos dois grupos estudados. RESULTADOS: Ambos os grupos apresentaram altos índices de perda auditiva, sendo observada, predominantemente, perda auditiva do tipo neurossensorial descendente, não havendo diferença estatisticamente significante entre os grupos. CONCLUSÃO: Diante desses dados, podemos concluir que a VPPB de canal posterior não tem influência sobre as características da perda auditiva em idosos, porém, devido à degeneração espontânea do sistema vestíbulo-coclear, tal população tem prevalência de perda auditiva.

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness; it constitutes the most common vestibular disorder in the elderly with vertigo. Its characteristic clinical aspect is dizziness at head movement, with not hearing alteration. AIM: This paper aims at studying the audiologic characteristics of elderly with BPPV of the posterior semicircular canal. MATERIALS AND METHODS: We carried out a retrospective analysis of threshold tonal audiometry exams of 37 senior citizens with posterior semicircular canal BPPV and also of 37 elderly without complaints of dizziness and/or vertigo, and we studied the audiologic characteristics of the two groups. RESULTS: Both groups had high rates of hearing loss, especially the descending curve sensorineural type, and there was no statistically significant difference between the groups. CONCLUSION: Having such data, we can conclude that posterior semicircular canal BPPV has no impact on the hearing loss features of senior citizens; nonetheless, because of the spontaneous degeneration of the vestibulocochlear system, such population has a prevalence of hearing loss.