Residual dizziness after therapeutic manoeuvres for BPPV: insights from vHIT and VNG

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. Despite appropriate treatment, some patients experience residual dizziness (RD), though the exact cause remains unknown. Whilst various studies have investigated vestibular tests in BPPV diagnosis and treatment effectiveness, no study has specifically evaluated videonystagmography (VNG) and video head impulse test (vHIT) parameters in BPPV patients with RD.

To evaluate whether VNG and vHIT can predict RD development in BPPV patients.

Thirty BPPV patients were divided into Group RD and Group C (control), based on RD presence despite absent positional nystagmus on second-day control after therapeutic manoeuvres. VNG and vHIT tests were performed before manoeuvres and at second-day follow-up.

No significant differences were observed between groups in average gain values of semicircular canals (p > 0.005). However, a statistically significant difference was found in right anterior-left posterior canal asymmetry (p = 0.020).

Despite the small sample size, vHIT asymmetry findings show promise for early RD detection in this frequently occurring disease group. Early identification may enable advance patient counselling, reduce anxiety, improve quality of life, and facilitate timely intervention with repeat manoeuvres or home exercises.