Subjective visual vertical in patients with benign paroxysmal positional vertigo

The ocular tilt reaction leads to an alteration in the subjective visual vertical (SVV). Nonsurgical peripheral vestibular dysfunction only rarely leads to changes in the SVV. To our knowledge, no studies have examined the effects on the SVV in patients with benign positional paroxysmal vertigo (BPPV) post Hallpike and Semont maneuvers. Sixteen patients with posterior canal BPPV were assessed in the vestibular clinic in Winnipeg, Manitoba. These patients had assessment of their SVV at baseline, post Hallpike and Semont maneuvers, and at follow-up 2 weeks later. These patients were also compared to a control group (n = 9). Ten of 16 patients showed a statistically significant change in SVV post Hallpike maneuver. An even larger number of patients, 14 of 16, showed a significant difference when compared to the control group post Hallpike. These findings suggest that the inferior vestibular nerve may to some degree influence the ocular tilt reaction.