Objectives: The purpose is to discuss the behavior of benign paroxysmal positional vertigo among the elderly population. Design: A total of 52 BPPV patients aged, 60 to 92 (mean age 70.7± 8.57) between April 2013 and November 2016 were included in the study. Visual images during diagnostic maneuvers were recorded and analyzed by videonistagmography (VNG). The European Evaluation of vertigo scale (EEV) was administered before and after the treatment. The R Project for Statistical Computing was used for statistical analyses. Results: 52 (9.4 %) elderly people over 132 total BPPV patients in Ozel Cevre Hospital, Istanbul, Turkey were included in the study. 63.5 % (33) of the BPPV were in posterior canals, 19.2 % (10) were in lateral canals, 17.3 % (9) were in anterior canals. 21.2% of the elderly population was secondary, 1.9 % was pluricanal (bilateral), 5.8% had canal changing patterns and 7.7% showed recurrence. The EEV value for all the patients before the therapeutic maneuvers was found to be 11.9 decreasing to 2.1 following the maneuvers. The result was meaningful with a pvalue = 6.907 * 10^ (-38) (<.0.05) (paired sample T test) Conclusion: The most popular canal was found to be the posterior canal among the elderly. With VNG, we can easily differentiate the positions of the debris in the exact canal and side. This gives accurate diagnosis and therapy with high success rate and a great comfort for the elderly people whose balance systems already degrade.

The analyses of benign paroxysmal positional verti̇go wi̇th videonystagmography among the elderly population

Objective: The objective of the present study was to meta-analyze relevant literature to gain a comprehensive understanding of the potential relationship between serum uric acid levels and risk of benign paroxysmal positional vertigo (BPPV). Methods: The databases of PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed were systematically searched for observational case-control studies of the association between BPPV and serum uric acid levels published up to October 2018. Data from eligible studies were meta-analyzed using Stata 12.0. Results: A total of 12 studies were included in the analysis. There was a strong tendency for serum uric acid levels to be associated with risk of BPPV among studies conducted in China (OR 0.69, 95%CI -0.01 to 1.40, p = 0.053), but not among studies outside China (OR 1.07, 95%CI -1.08 to 3.22, p = 0.33). Across all studies, serum uric acid level was significantly higher among individuals with BPPV than among controls (OR 0.78, 95%CI 0.15 to 1.41, p = 0.015), yet it did not independently predict risk of the disorder (OR 1.003, 95%CI 0.995 to 1.012, p = 0.471). Conclusion: The available evidence suggests that BPPV is associated with elevated levels of serum uric acid, but these levels may not be an independent risk factor of BPPV.

/pdf/association-between-serum-uric-acid-levels-and-benign-16c05j1g44.pdf

Association Between Serum Uric Acid Levels and Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis of Observational Studies.

Objective
To investigate the relationship between benign paroxysmal positional dizziness (BPPV) and cerebrovascular disease and to promotethe practice of evidence-bases medicinein thediagnosis, treatment and recurrenceprevention of BPPV in the elderly.


Methods
A total of 80 elderly patients were consecutively recruited from the Dizziness Outpatient Clinic from January 2013 to June, 2014, with 80 non-BPPV elderly individuals receiving routine physical checkups during the same period serving as the control group.Clinical characteristics, lab test results and imaging data were compared between the two groups.Single factor and multivariate logistic regression analyses were conducted to identify independent risk factors for BPPV in the elderly.


Results
The experimental group showed higher rates of lacunar infarction, leukoaraiosis and intracranial artery stenosis than the control group(χ2=10.180, 4.606 and 3.956, respectively; P=0.001, 0.032 and 0.047, respectively). The prevalences of hyperlipidemia and type 2 diabetes were higher in the BPPV group than in the control group(χ2=5.013 and 6.041, respectively; P=0.025 and 0.014, respectively). Differences in number of carotid atherosclerotic plaque cases, total cholesterol, triglyceride, homocysteine and uric were found between the two groups (χ2=11.237, t=2.862, 2.230 and 4.270, respectively; P=0.001, 0.005, 0.027 and 0.000, respectively). Multivariate logistic regression analysisfound that blood uric acid, hyperglycemia, type 2 diabetes and hypertension were independent risk factors for BPPV (OR=1.006, 7.104, 3.152 and 3.273, respectively; P=0.005, 0.000, 0.004 and 0.002, respectively). The existence of carotid atherosclerotic plaques also increased the risk of BPPV(OR=384.570, 95%CI: 46.935~3151.055, P=0.000).


Conclusions
BPPV in the elderlyis closely associated with cerebrovascular disease and its risk factors.Therefore, it is of great clinical significance to assess cerebrovascular function and carotid atherosclerotic plaque development for improved prognosis and effective prevention of recurrence of BPPV in the elderly.


Key words: 
Vertigo; Cerebrovascular disorders

The relationship between benign paroxysmal positional vertigo and cerebrovascular disease in the elderly

Objective:To analyze clinical features with benign paroxysmal positional vertigo(BPPV)and discuss the attentions in the canalith repositioning procedures.Method:A total of 76 male and female patients aged 80 and over with BPPV(elderly group)and 76 patients aged 60-65 years old with BPPV(older group)was retrospectively analyzed.Result:1Semicircular canal condition:in elderly group,posterior semicircular canal was involved in 72 cases,whereas the horizontal semicircular 4cases.In older group,posterior semicircular canal was involved in 70 cases,whereas the horizontal semicircular and multiple canals in 5cases and 1case respectively.2Precipitating factors:precipitating factors of elderly were variety.It′s closely related with emotion,infection,seasonal alternation surgery,and trauma.There were significant differences between the two groups(P0.05).3The symptoms of undergoing treatment and post-treatment:the duration of dizziness and carebaria were significant difference after canalith repositioning procedure t reatment between two groups(P0.05),the duration of balance disturbance and symptoms of vegetative nerve functional disturbance like nausea and sweating were significant difference(P0.05).4Treatment and outcomes:the remission,partial remission rate were 34.2%,81.6%respectively,after the first or second time of repositioning treatment.The efficacy of repositioning treating at the first time was significantly different between two groups(P0.05).It was poor efficacy in elderly group.There is no difference in efficacy for repositioning treatment at the second or third time(P0.05).5The elderly always accompanied with other medical condition and had risk factors of cerebrovascular disease.The efficacy was not associated with the complication(P0.05).However,it was most likely to overtreatment caused by emphasizing other medical conditions treatment.BPPV was easy to ignore and misdiagnose,meanwhile,delayed the diagnosis and increased the medical costs.6Many elderly were accompanied cervical spondylosis,lumbar spondylosis body stiffness and fear of vertigo which increased the difficulty of repositioning treatment.7Recurrence:we followed up2 years after treatment.In older group,11 patients(14.5%)were relapsed.In elderly group,29 patients(38.2%)relapsed.There were significant differences between the two groups(P0.05).Conclusion:There are various precipitating factors in elderly patients with BPPV,the most frequent precipitating factors were related to psychological factor and overfatigue.The symptoms of the patients attack BPPV was always mask with other diseases,but do not impact on the efficacy of Canalith repositioning at the first time;Even the efficacy of repositioning is poor at the first time,it′s effective and safety after multiple treatments of repositioning;It prolonged the symptoms including carenaria,dizziness and nausea after treatment.

Analysis of clinical features with benign paroxysmal positional vertigo in elderly patients and precautions for canalith repositioning procedure treatment

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The relationship between benign paroxysmal positional vertigo and cerebrovascular disease in the elderly

Analysis of clinical features with benign paroxysmal positional vertigo in elderly patients and precautions for canalith repositioning procedure treatment