![]() ![]() The purpose of this study is to determine whether the patients with BPPV have a tendency to develop the same type of BPPV on the same side during recurrences of BPPV, which would aid in guiding the patients to treat recurred BPPV for themselves by adopting self-administration of an appropriate CRP. In this study, we analyzed the involved canal and type of BPPV during the consecutive pairs of attacks in patients with recurrent BPPV. Until now, few studies have explored the patterns of canal involvement during recurrences of BPPV ( 12, 14). Since BPPV recurs frequently with an annual recurrence rate of 15–18% ( 12, 13), self-administration of CRP may be attempted when BPPV recurs if each patient has a predilection for a specific canal, and the affected canal can be predicted based on the involved canal and type of BPPV during the previous event. Indeed, addition of self-applied CRP at home was more effective than the CRP alone performed by the clinician ( 9– 11). By virtue of its relative easiness, CRP may be attempted by the patients. Since CRP differs according to the involved canal, accurate identification of the affected canal is essential for applying an appropriate CRP to each patient with BPPV. CRP results in immediate resolution of BPPV in about 80% of patients after single application, and the success rate increase up to 92% with repetition of the procedure ( 8). Canalith repositioning procedures (CRPs) can effectively treat BPPV ( 4– 7). When there is a change in the static position of the head with respect to gravity, the otolithic debris moves to a new dependent position within the semicircular canals, leading to a false sense of rotation ( 1). BPPV is caused by dislodged otoconia that enter the semicircular canals ( 1– 3). Instruction for self-administration of a specific canalith repositioning procedure based on the previous type of BPPV may have a limited efficacy in this frequently recurrent disorder.īenign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo and is found in 17–42% of patients with vertigo ( 1). Only 24% of the patients showed the recurrence in the same canal on the same side.Ĭonclusion: The patterns of recurrences are usually discordant in patients with BPPV. During the recurrences, the proportions of involved canals and affected side were similar irrespective of those during the former event. Two patients (0.9%) showed bilateral involvements. The right ear was more commonly affected than the left ear. Results: During the initial attack, the involved canals were posterior in 134 (59.8%), geotropic horizontal in 53 (23.7%), apogeotropic horizontal in 27 (12.1%), anterior in 5 (2.2%), and mixed in 5 (2.2%). We defined the recurrence when patients had the redevelopment of BPPV at least 1 week after resolution of the previous one. ![]() Methods: The involved side (right, left, and bilateral) and affected canal (posterior, geotropic horizontal, apogeotropic horizontal, anterior, and mixed) were analyzed in 224 pairs of consecutive attacks of BPPV confirmed in 167 patients at the Dizziness Clinic of Seoul National Bundang Hospital from 2003 to 2017. This study aims to determine that each patient with BPPV has a predilection for a specific canal and the type of recurred BPPV can be predicted from that observed during the previous attack. 2Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, Seongnam, South Koreaīackground and Objectives: Benign paroxysmal positional vertigo (BPPV) recurs frequently.1Research Administration Team, Seoul National University Bundang Hospital, Seongnam, South Korea.
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