Video head impulse testing before and after canalith repositioning for benign paroxysmal positional vertigo

Area of Science:

• Neurology
• Ophthalmology
• Otolaryngology

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.
• Canalith repositioning maneuvers (CRMs) are effective treatments for BPPV.
• Video head impulse testing (vHIT) assesses vestibulo-ocular reflex (VOR) function.

Purpose of the Study:

• To evaluate video head impulse testing (vHIT) outcomes in patients with benign paroxysmal positional vertigo (BPPV) before and after canalith repositioning maneuvers (CRMs).
• To determine the incremental value of vHIT in assessing BPPV treatment efficacy.

Main Methods:

• Prospective before-after study involving 63 patients diagnosed with BPPV.
• vHIT was performed to measure vestibulo-ocular reflex (VOR) gain in all 6 semicircular canals.
• Dizziness Handicap Inventory (DHI) scores were collected before and after CRM.

Main Results:

• Most patients (93.7%) had normal VOR gains pre-treatment.
• No significant differences in VOR gain were observed pre-treatment, immediately post-treatment, or 1 week after CRM.
• No corrective saccades were detected in any patient.

Conclusions:

• vHIT demonstrated no significant post-treatment changes in VOR gain for BPPV patients.
• vHIT may have limited additional diagnostic value in the routine evaluation of isolated BPPV cases following CRM.