Neuro- Otological evaluation abnormality and their management in Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common cause of giddiness of peripheral vestibular disorders. Canalolith repositioning (CRP) is the main stay for treatment for BPPV. Despite the fact CRP can provide rapid relief of giddiness in BPPV patients, residual dizziness (RD)may remain in spite of disappearance of typical vertigo and nystagmus following successful CRP. This study enumerates various neuro-otological abnormalities in addition to BPPV and the treatment response of residual dizziness to vestibular rehabilitation (VR). This is a prospective study of 88 diagnosed as BPPV by positional tests, the various neuro-otological abnormalities are documented along with the dizziness handicap inventory. After successful CRP, vestibular rehabilitation was initiated for the vestibular dysfunction and is noted. In our study of 88 patients, in addition to the semicircular canal abnormality by positional test, the other neuro-otological dysfunction/abnormalities noted are Subjective visual vertical (SVV) abnormal in 61 patients, Dynamic visual acuity (DVA) reduced in 48 patients, Craniocorporography (CCG) abnormality in 52 patients. In the following 76 patients have no further episodes of vertigo for 6 months, while 8 patients had 2 episodes of brief few seconds of giddiness lasting less than 5 seconds and 4 had one episodes of 5 seconds after treating the BPPV by CRP manoeuvres and started on VRT. In the end of six months follow up all our patients were better with no episodes of dizziness. Though BPPV is one of the common causes of vertigo, the battery of neuro-otological tests, has to be performed to treat the various underlying dysfunction, which causes residual dizziness needed to be managed by vestibular rehabilitation.