Autonomic dysfunction as a possible cause of residual dizziness after successful treatment in benign paroxysmal positional vertigo

作者：Kim Hyun Ah; Lee Hyung^*

来源：Clinical Neurophysiology, 2014, 125(3): 608-614.

DOI：10.1016/j.clinph.2013.08.008

• BPPV
• Residual dizziness
• Autonomic dysfunction

Objective: To investigate whether residual dizziness after successful treatment in patients with benign paroxysmal positional vertigo (BPPV) was associated with autonomic dysfunction.
Methods: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures (CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and divided into two groups with and without residual dizziness. We performed a standardized autonomic function test.
Results: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the next follow-up than those without residual dizziness (40% and 3%, p = 0.000). Compared to patients without residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different between the patients with and without residual dizziness.
Conclusion: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural autonomic dysfunction.
Significance: This investigation could be useful in understanding the mechanism of residual dizziness in patients with BPPV.

• 出版日期2014-3