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Clinical Evaluation of Benign Paroxysmal Positional Vertigo in Patients after Mild to Moderate Head Trauma
Suryakant Tiwari1, Nitin Kumar Jain1, Salabh Kumar Agrawal1
1Department of ENT, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
Background:
Benign paroxysmal positional vertigo (BPPV) is a common sequelae of head trauma, yet its incidence, clinical profile, and response to treatment remain underreported in patients with mild to moderate head injury. This study aimed to evaluate the clinical characteristics and treatment outcomes of BPPV in such patients.
Materials And Methods:
A prospective observational study was conducted in a tertiary care hospital. A total of 120 patients aged 18-65 years with mild to moderate head trauma and subsequent vertiginous symptoms were evaluated. Clinical assessment included Dix-Hallpike and supine roll tests to confirm BPPV and determine canal involvement. Patients underwent appropriate canalith repositioning maneuvers and were followed up at 1 week, 1 month, and 3 months.
Results:
Of 120 patients (mean age 41.8 years; 61.7% male), road traffic accidents accounted for 56.7% of injuries. BPPV was diagnosed in 22 cases (18.3%). The posterior semicircular canal was most frequently involved (68.2%), followed by horizontal (27.3%) and anterior canals (4.5%). BPPV was more frequent in patients with road traffic accidents (20.6%) compared to falls (18.8%) or domestic slips (10.0%), though the difference was not significant (P = 0.31). Following repositioning maneuvers, complete relief was achieved in 72.7% at 1 week, 90.9% at 1 month, and 100% at 3 months, with no recurrences observed.
Conclusion:
Nearly one-fifth of patients with mild to moderate head trauma developed BPPV, predominantly affecting the posterior canal. Canalith repositioning maneuvers were highly effective, ensuring complete recovery without recurrence.
