Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/69761
Title: Healing criteria: How should an episode of benign paroxistic positional vertigo of posterior semicircular canal′s resolution be defined? Prospective observational study
Authors: Guerra-Jiménez, G.
Domènech-Vadillo, E.
Álvarez-Morujo de Sande, M. G.
González-Aguado, R.
Galera-Ruiz, H.
Morales Angulo, C.
Martín-Mateos, A. J.
Figuerola-Massana, E.
Ramos Macías, Ángel Manuel 
Domínguez-Durán, E.
UNESCO Clasification: 321305 Cirugía de garganta, nariz y oídos
Keywords: BPPV
Epley Maneuver
Nystagmus
Positional Nystagmus
Positional Vertigo
Issue Date: 2019
Journal: Clinical Otolaryngology 
Abstract: Objectives: To compare the outcome of the Epley maneuver (EM) in benign paroxysmal positional vertigo of the posterior canal (CSP-BPPV) depending on the definition used for recovery. Design: Multicenter observational prospective study. Setting: Otoneurology Units of 5 tertiary reference hospitals. Participants: All patients presenting with unilateral CSP-BPPV assisted for 1-year period. Exclusion criteria: Spontaneous nystagmus, positive McClure-Pagnini maneuver, positive bilateral Dix-Hallpike maneuver (DHM), positive DHM for vertigo but negative for nystagmus and atypical nystagmus. Main outcome measures: Response to EM was measured after 7 days in 3 different outcomes: disappearance of nystagmus during the DHM in the follow-up visit, disappearance of vertigo during the DHM and general status (GS) during daily life activities. Results: 264 patients were recruited (68 male/166 female, mean age 62 years). After the EM, nystagmus disappeared in 67% of them, vertigo in 54% and 36% were asymptomatic in their daily life. These outcomes were strongly correlated, but they were not concordant in a clinically significant group of cases; only the 26% of patients met all of them. The healing process follows the next sequence: negativization of positional nystagmus, then disappearance of positional vertigo and, finally, the improvement of GS during daily life activities. Conclusion: Nowadays, healing criteria for the resolution of an PSC-BPPV episode have not been specifically defined yet. Provided that other otoneurological disorders have been ruled out, the next resolution criterion is proposed: absence of nystagmus and specifically during control DHM and disappearance of symptoms during daily life activities.
URI: http://hdl.handle.net/10553/69761
ISSN: 1749-4478
DOI: 10.1111/coa.13173
Source: Clinical Otolaryngology [ISSN 1749-4478], v. 44 (3), p. 219-226
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