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Subjective visual vertical in patients with benign paroxysmal positional vertigo
R M Gall1, D J Ireland, D D Robertson
1Department of Otolaryngology, University of Manitoba, Winnipeg.
The Journal of Otolaryngology
|July 20, 1999
Summary
Benign positional paroxysmal vertigo (BPPV) maneuvers can alter the subjective visual vertical (SVV). This study found significant SVV changes in BPPV patients after Hallpike maneuvers, suggesting vestibular nerve influence.
Area of Science:
- Neurology
- Ophthalmology
- Vestibular Science
Background:
- The ocular tilt reaction (OTR) impacts the subjective visual vertical (SVV).
- Peripheral vestibular dysfunction infrequently alters SVV.
- No prior studies investigated SVV changes in benign positional paroxysmal vertigo (BPPV) patients following diagnostic maneuvers.
Purpose of the Study:
- To evaluate the effect of Hallpike and Semont maneuvers on SVV in patients with posterior canal BPPV.
- To compare SVV changes in BPPV patients to a control group.
Main Methods:
- Sixteen patients with posterior canal BPPV underwent SVV assessment.
- Assessments were performed at baseline, post-Hallpike and Semont maneuvers, and at a 2-week follow-up.
- A control group of nine individuals was included for comparison.
Main Results:
- Ten of sixteen BPPV patients exhibited a statistically significant SVV change post-Hallpike maneuver.
- Fourteen of sixteen BPPV patients showed a significant SVV difference compared to controls after the Hallpike maneuver.
- A notable proportion of patients experienced altered SVV following vestibular maneuvers.
Conclusions:
- Hallpike and Semont maneuvers can induce significant alterations in the subjective visual vertical in BPPV patients.
- These findings suggest a potential role for the inferior vestibular nerve in modulating the ocular tilt reaction.
- Further research is warranted to elucidate the precise mechanisms linking BPPV, vestibular maneuvers, and SVV changes.