Objective:To study the potential role of subjective visual vertical(SVV)as a prognostic marker for canalith repositioning maneuver(CRM)in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV)for ...Objective:To study the potential role of subjective visual vertical(SVV)as a prognostic marker for canalith repositioning maneuver(CRM)in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV)for the Indian population.Methods:SVV was examined in 30 patients with PC-BPPV before and after canalith repositioning maneuver and after complete resolution of PC-BPPV.Study parameters included the mean of 10 angular tilt readings and direction of deviation,which were compared before and after CRM and following complete resolution of PC-BPPV.Results:The angle of SVV tilt was greater and deviated towards the affected ear before CRM in all patients,which decreased significantly shortly after CRM and continued to decrease after complete resolution of PC-BPPV(p<0.0001).Conclusions:SVV can be used to test utricular dysfunction in PC-BPPV.The angle of tilt improves in response to CRM,which may be used as a prognostic marker in patients with PC-BPPV receiving CRM.展开更多
Objective:Epley maneuver is the most effective treatment for benign paroxysmal positional vertigo(BPPV).Betahistine has been shown to be effective in treating BPPV.This systematic review aims to compare the effectiven...Objective:Epley maneuver is the most effective treatment for benign paroxysmal positional vertigo(BPPV).Betahistine has been shown to be effective in treating BPPV.This systematic review aims to compare the effectiveness of Epley maneuver with betahistine to Epley maneuver alone in reducing residual dizziness in BPPV.Data Sources:Medline,Embase,and CENTRAL.Methods:We included randomized controlled trials(RCTs)that compared Epley maneuver with betahistine to Epley maneuver alone for treating BPPV.We evaluated the effectiveness of this intervention using Dizziness Handicap Inventory(DHI),Visual Analog Scale(VAS)for vertigo,and provocation maneuvers.We used the standardized mean difference(SMD)for continuous outcomes and the odds ratio(OR)for the dichotomous outcomes.Results:A total of eight RCTs that enrolled 516 participants were deemed eligible.Administration of betahistine with Epley maneuver showed no clinically significant difference over Epley maneuver alone in DHI score(SMD:−0.11,95%confidence interval[CI],−0.57 to 0.34,p=0.63,I^(2)=79%),VAS scores(SMD:−0.57,95%CI,−1.57 to 0.43,p=0.26,I^(2)=89%),or on provocation maneuvers(OR:1.84,95%CI,0.92 to 3.68,p=0.08,I^(2)=0%)after 1 week of betahistine administration.However,participants who received betahistine combined with Epley maneuver showed a statistically significant reduction in VAS scores after 4 weeks of betahistine administration(SMD:−0.89,95%CI,−1.30 to−0.49,p<0.0001,I^(2)=33%).Conclusion:Combining betahistine with Epley maneuver could improve the outcomes of BPPV in the long term.However,clinical trials with longer follow-up periods are needed to unravel its efficacy.展开更多
文摘Objective:To study the potential role of subjective visual vertical(SVV)as a prognostic marker for canalith repositioning maneuver(CRM)in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV)for the Indian population.Methods:SVV was examined in 30 patients with PC-BPPV before and after canalith repositioning maneuver and after complete resolution of PC-BPPV.Study parameters included the mean of 10 angular tilt readings and direction of deviation,which were compared before and after CRM and following complete resolution of PC-BPPV.Results:The angle of SVV tilt was greater and deviated towards the affected ear before CRM in all patients,which decreased significantly shortly after CRM and continued to decrease after complete resolution of PC-BPPV(p<0.0001).Conclusions:SVV can be used to test utricular dysfunction in PC-BPPV.The angle of tilt improves in response to CRM,which may be used as a prognostic marker in patients with PC-BPPV receiving CRM.
基金Received:16 October 2023|Accepted:12 December 2023。
文摘Objective:Epley maneuver is the most effective treatment for benign paroxysmal positional vertigo(BPPV).Betahistine has been shown to be effective in treating BPPV.This systematic review aims to compare the effectiveness of Epley maneuver with betahistine to Epley maneuver alone in reducing residual dizziness in BPPV.Data Sources:Medline,Embase,and CENTRAL.Methods:We included randomized controlled trials(RCTs)that compared Epley maneuver with betahistine to Epley maneuver alone for treating BPPV.We evaluated the effectiveness of this intervention using Dizziness Handicap Inventory(DHI),Visual Analog Scale(VAS)for vertigo,and provocation maneuvers.We used the standardized mean difference(SMD)for continuous outcomes and the odds ratio(OR)for the dichotomous outcomes.Results:A total of eight RCTs that enrolled 516 participants were deemed eligible.Administration of betahistine with Epley maneuver showed no clinically significant difference over Epley maneuver alone in DHI score(SMD:−0.11,95%confidence interval[CI],−0.57 to 0.34,p=0.63,I^(2)=79%),VAS scores(SMD:−0.57,95%CI,−1.57 to 0.43,p=0.26,I^(2)=89%),or on provocation maneuvers(OR:1.84,95%CI,0.92 to 3.68,p=0.08,I^(2)=0%)after 1 week of betahistine administration.However,participants who received betahistine combined with Epley maneuver showed a statistically significant reduction in VAS scores after 4 weeks of betahistine administration(SMD:−0.89,95%CI,−1.30 to−0.49,p<0.0001,I^(2)=33%).Conclusion:Combining betahistine with Epley maneuver could improve the outcomes of BPPV in the long term.However,clinical trials with longer follow-up periods are needed to unravel its efficacy.
