Presentation and outcome of post-traumatic benign paroxysmal positional vertigo

The clinical presentation and outcome of post-traumatic benign paroxysmal positional vertigo (t-BPPV) are different from those idiopathic BPPV (i-BPPV). It appears that t-BPPV is more difficult to treat than i-BPPV.

To identify the clinical presentation and outcome of t-BPPV.

We reviewed the medical records of 40 patients with BPPV after head injury during the period 2004-2011. The outcome was compared with the outcome of 46 patients with i-BPPV who were treated over the same period.

In all, 55% of patients with t-BPPV had involvement of two or more semicircular canals (SCCs) in comparison with 6.5% of patients with i-BPPV (p < 0.01). Also, 25% of patients with t-BPPV had involvement of bilateral SCCs in comparison with 2% of patients with i-BPPV (p < 0.01). We found that 35% of patients with t-BPPV were free of the symptoms and signs after a single physical repositioning maneuver, in comparison with 84% of patients with i-BPPV (p < 0.001). During a 1-year follow-up, 67% of patients with t-BPPV and 12% of patients with i-BPPV had a recurrent attack (p < 0.001).