- M Gizzi, S Ayyagari, V Khattar (Seton Hall Univ, Edison, NJ; Robert Wood Johnson Med School, New Brunswick, NJ)
The Familial Incidence of Benign Paroxysmal Positional Vertigo.
Acta Otolaryngol (Stockh) 118: 774-777, 1998.
More than 50% of cases are idiopathic in nature. Why otoconia became dislodged is not known. The possibility of familial tendency is investigated.
120 consecutive patients with B.P.P.V. and 120 cases of dizziness without B.P.P.V. were surveyed. Family members of both, were interrogated for frequency of dizziness and B.P.P.V. Patients with B.P.P.V., family members were five times more affected by B.P.P.V. as against patients with dizziness without B.P.P.V.
In conclusion – The occurrence of B.P.P.V. appears to have familial tendency. Whether this is the result of hereditary or environmental influence cannot be determined by this data.
This article suggests that relatives of patients with B.P.P.V. have 5 times more tendency to develop B.P.P.V. More studies are needed. – R. J. Tusa.
- Nuti D, Agus G, Barbieri M-T, et al (Univ of Siena, Italy; Univ of Cagliari, Italy)
The Management of Horizontal – Canal Paroxysmal Positional Vertigo
Acta Otolaryngol (Stockh) 118:455-460, 1998
This lesion causes more intense vertigo, mainly because of rotatory movements of the head or body in the supine position, with horizontal nystagmus.
Physical therapy includes two different techniques and has been evaluated in a 2-center study.
Barbecue rotation approach, in which head is rapidly rotated in the direction of healthy ear in 4 steps in an attempt to expel otoconia. 63 patients were treated with forced prolonged position (FPP) – in which the patient lies on the affected side for many hours in an attempt to dislodge otoconia. In 71% cases barbecue procedure showed successful resolution and in 73% cases FPP showed success. Barbecue procedure achieves success quickly while the latter procedure takes longer time.
Both procedures relieve the problem. Authors further suggest that both procedures should be done in succession. Barbecue procedure is followed by FPP in which patient lies for few hours on unaffected side.
This occurs in 3% to 5% cases. The authors have tried barbecue procedure successfully for years. The authors usually have patients stay upright for few hours after the maneuver.
Further studies are needed to confirm that successful results can be achieved by allowing patients to sleep on the “good ear” for a few nights after the maneuver.