Benign paroxysmal positional vertigo in Parkinson's disease

Area of Science:

• Neurology
• Otolaryngology
• Movement Disorders

Background:

• Dizziness is a common symptom in Parkinson's disease (PD).
• Orthostatic hypotension (OH) is frequently implicated as the cause of dizziness in PD.
• This study investigated benign paroxysmal positional vertigo (BPPV) as an alternative cause of dizziness in PD patients.

Purpose of the Study:

• To determine the prevalence of BPPV in Parkinson's disease patients.
• To assess BPPV in PD patients experiencing dizziness and those without dizziness.
• To evaluate the efficacy of BPPV treatment in PD patients.

Main Methods:

• 305 PD outpatients underwent neurological and vestibular assessments.
• Assessments included the Movement Disorders Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, Dizziness Handicap Inventory, Dix-Hallpike maneuver, and orthostatic hypotension testing.
• Patients diagnosed with BPPV received a repositioning maneuver and were followed for three months.

Main Results:

• 151 out of 305 (49%) PD patients reported dizziness.
• Orthostatic hypotension was identified in 57% of dizzy patients.
• Benign paroxysmal positional vertigo was diagnosed in 12 (8%) with classical presentation and 4 (3%) with atypical presentation, totaling 5.3% of all PD patients.
• 11 out of 12 (92%) patients with classical BPPV experienced significant symptom improvement after treatment.
• No BPPV was found in PD patients without dizziness.

Conclusions:

• Benign paroxysmal positional vertigo is a significant, treatable cause of dizziness in Parkinson's disease patients.
• Up to 11% of dizzy Parkinson's patients may have BPPV.
• Routine screening for BPPV in dizzy PD patients is recommended for effective management.