Traumatic benign paroxysmal positional vertigo: personal experience and comparison with idiopathic BPPV

Area of Science:

• Neurology
• Otolaryngology
• Vestibular System Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.
• Approximately 15% of BPPV cases have a post-traumatic origin.
• The management and prognosis, particularly recurrence, of traumatic BPPV (T-BPPV) remain subjects of debate.

Purpose of the Study:

• To compare the characteristics and outcomes of T-BPPV with idiopathic BPPV (I-BPPV).

Main Methods:

• Analysis of data from 795 BPPV patients (716 I-BPPV, 79 T-BPPV).
• Evaluation of clinical history and bedside examinations.
• Treatment with repositioning maneuvers and reassessment until symptom resolution.

Main Results:

• T-BPPV exhibited a significantly higher persistence rate (12.6% vs. 5%) and a greater likelihood of bilateral or multi-canal involvement compared to I-BPPV.
• The resolution rate with a single maneuver was lower for T-BPPV.
• Recurrence rates were similar between T-BPPV (38%) and I-BPPV (30.6%).

Conclusions:

• T-BPPV differs from I-BPPV in resolution rate, extent of canal involvement, and persistence.
• Despite initial differences, the long-term natural course of T-BPPV and I-BPPV appears similar after symptom resolution.