Evaluation of the vestibular and balance system in BPPV patients before and after repositioning Maneuver

Abstract

SUMMARY T he present study was done to determine the associated balance dysfunction in BPPV, to detect the effect of repositioning on balance function if any after CRP and also to plan appropriate management after CRP. The study was conducted on 30 patients diagnosed with benign paroxysmal positional vertigo recruited from balance clinic, Ain Shams university hospital. All patients had full history, physical examination, video-nystagmography test, cervical vestibular evoked myogenic potential test, posturography test including sensory organization test and adaptation test then the CRP was done. After two weeks the cervical vestibular evoked myogenic potential test and posturography test was done again to evaluate the effect of CRP. There was a significant improvement in sensory organization test (Condition 5, Condition 6 and Equilibrium scores) after CRP. However, there was no statistically significant difference in cervical vestibular evoked myogenic potential test and adaptation test before and after CRP. Most of BPPV patients with residual abnormal SOT scores improved to normal scores after vestibular rehabilitation. These findings were consistent with most of the previous studies in the same field except there were some controversies about the cervical vestibular evoked myogenic potential test findings before and after CRP application. So, the present study found that dynamic posturography can quantitatively analyze postural balance, and is helpful in comprehensive evaluation of the vestibular function of BPPV patients. Impaired balance often presents in patients with BPPV. Treatment of BPPV using the CRP results in improved postural stability in static and dynamic posturography; while vestibular rehabilitation significantly improve the balance scores in BPPV patients who had residual abnormal SOT scores after CRP