Video Occulography-Assisted Diagnosis of BPPV and Comparison of Pre- and Post-Intervention Dizziness Handicap Inventory Score

Sidra Khan, R. Agrawal, S. Nivsarkar, Shrikant Phatak, A. Sikdar
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Abstract

Abstract Benign paroxysmal positional vertigo (BPPV) is a commonly recognized vestibular disorder which is characterized by brief periods of vertigo and a characteristic nystagmus. The nystagmus is often difficult to appreciate with naked eyes and hence video oculography is a helpful tool. Dizziness Handicap Inventory is an objective way to assess the impact of vertigo on quality of life. Objective Our study here aims at diagnosing undiagnosed, difficult and missed cases of BPPV using video-oculography and managing it with repositioning manoeuvre. This study also aims at measuring Dizziness Handicap Inventory Scores pre and post repositioning manoeuvre. We also observed the association between Vitamin D levels and the occurrence of BPPV. Methods and Materials One hundred and twenty-six patients were enrolled in the age group of 18-70 years. After recognizing patients with BPPV, vertigo evaluation was performed. Those patients with suggestive history and suspicion of multiple canal involvement were taken for video-oculography. Results Forty-four patients were in age group of 50-60 years, having female predominance. 35.71% cases which were missed on clinical examination were correctly diagnosed using video-oculography. The mean pre-intervention DHI was 41.29 ± 15.90 which lowered down to 14.84 ± 11.52 in post-intervention period. The highest DHI scores were seen in multi-canal BPPV involving lateral and posterior semi-circular canals. Conclusion With the help of vide-oculography we could diagnose more cases of anterior and multi canal BPPV which are often missed. Maximum number of participants had insufficient levels of Vitamin-D and in our opinion correcting it would reduce the occurrence and recurrence rate..
视频定位辅助诊断BPPV及干预前后头晕障碍量表评分比较
良性阵发性位置性眩晕(BPPV)是一种公认的前庭疾病,其特征是短暂的眩晕和特征性的眼球震颤。眼球震颤通常很难用肉眼观察到,因此视频眼科检查是一个有用的工具。眩晕障碍量表是评估眩晕对生活质量影响的客观方法。目的应用视像视觉术诊断未确诊、难治性和漏诊的BPPV,并采用复位手法进行治疗。本研究亦旨在测量重定位动作前后的眩晕障碍量表得分。我们还观察到维生素D水平与BPPV的发生之间的联系。方法与材料纳入126例患者,年龄18 ~ 70岁。在识别出BPPV患者后,进行眩晕评估。对有提示病史及怀疑累及多根椎管的患者行视像视觉摄影。结果44例患者年龄50 ~ 60岁,以女性为主。35.71%的临床漏诊病例经视像眼底造影正确诊断。干预前DHI均值为41.29±15.90,干预后DHI均值为14.84±11.52。DHI评分最高的是涉及外侧和后半圆形管的多管BPPV。结论视像眼底造影可诊断出较多易漏诊的前管及多管BPPV。大多数参与者维生素d水平不足,在我们看来,纠正它将减少发生和复发率。
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