Management of recurrent benign paroxysmal positional vertigo

Area of Science:

• Neurology
• Otolaryngology
• Vestibular Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common episodic vestibular disorder.
• Diagnosis is often difficult due to symptom quiescence by the time of specialist consultation.
• Patients experience anxiety regarding potential BPPV relapse and require clear follow-up guidance.

Purpose of the Study:

• To evaluate the effectiveness of an open-access pathway offering priority appointments for patients with a history of positional vertigo.
• To assess the impact of this pathway on diagnostic rates and the management of recurrent BPPV.

Main Methods:

• Retrospective analysis of 664 patients with a history of positional vertigo.
• Inclusion in an open-access pathway with priority appointments.
• Analysis of diagnostic outcomes and recurrence rates based on follow-up duration.

Main Results:

• 52% of patients had unconfirmed BPPV at initial assessment.
• The open-access pathway improved diagnostic rates by approximately 40%.
• Recurrence rates increased with longer follow-up: 34% (≥1 year), 41% (1-2 years), and 53% (≥2 years).
• 1 in 5 recurrences involved a different semi-circular canal.

Conclusions:

• Specialist follow-up is crucial for managing recurrent benign paroxysmal positional vertigo.
• An open-access pathway can enhance diagnostic accuracy for BPPV.
• Understanding recurrence patterns, including canal involvement, informs patient management strategies.