Clinical Characteristics And Analysis Of Curative Effect In Patients With Benign Paroxysmal Positional Vertigo

【Objective】Firstly, through prospective design, analyzing medical records of patients from vertigo clinic of neurology department in the First Affiliated Hospital of Soochow University, choosing patients with benign paroxysmal positional vertigo(BPPV) which is the most common form of vertigo. we summarized Clinical characteristics and grouping of BPPV, the therapeutic method and effect of Canalith Repositioning Maneuver(CRM) between different subtype in order to direct future clinical medication. Secondly, comparing the patients'function, affection and aspect of physiology between before and after treatment combining according to the Dizziness Handicap Inventory(DHI) score, in order to judge the curative effect better.【Methods】Collecting the medical records of 268 patients with BPPV from vertigo clinic in the First Affiliated Hospital of Soochow University, between 0ctober, 2006 and October 2007, who presented occurring with changes of head position and transient vertigo at onset.ProcedureConduct a thorough history and physical examination, auxiliary examination, diagnosis and differential diagnosis, corresponding treatment.Procedure of diagnosis and differential diagnosisIdentify the true dizziness and pseudo-dizziness. If it was the true dizziness, we distinguished the peripheral and central vestibular disorder. If the former, we ascertained BPPV. Finally, we differentiated primary or secondary BPPV and classified it, such as: Posterior Semicircular Canal BPPV(PSC-BPPV), Horizontal Semicircular Canal BPPV(HSC-BPPV), Anterior Semicircular Canal BPPV,(ASC-BPPV) and Mixing Semicircular Canal BPPV(MSC-BPPV). We identified the etiology or induced factor as far as possible by history and auxiliary examination.Canalith Repositioning Maneuver(CRM)Patients with different type of Semicircular Canal BPPV were given corresponding CRM.Dizziness Handicap Inventory(DHI) scoreDHI was designed to assess perceptive dysfunction caused by vestibular disorders. DHI can quantified judge the effect of age, sex, etiology, course and severity of illness on BPPV patients'daily life, and also can quantified evaluate the improvement on function, affection and physiology.【Results】In patients with BPPV, the incidence of female is 63.8%. Patients of age 50-70 account for 58.2%. The incidence of Primary BPPV is 89.9%,,And in secondary BPPV, patients with history of head injury account for 29.7%. In Primary BPPV, patients with course less than 3 months account for 63.5%, and 20.3% with course more than 12 months. In secondary BPPV, the former is 48.2%, while the latter is 40.7%. The incidence of PSC-BPPV in all patients with BPPV is 81.7%, and Right-Sided BPPV accounts for 54.4%. In primary BPPV, patients predominantly present vertigo, nystagmus,, nausea and vomiting, and all people have no symptom of eyes and ears, cervical and central nervous system. While in secondary BPPV, patients often accompany auditory and neurologic symptoms or vestibular dysfunction other than three main symptoms. CRM demonstrates an 98.7%cure or improvement in primary BPPV, and 96.3% in secondary BPPV. 7 patients with primary BPPV, without CRM present self-cure, who are considered as PSC-BPPV. The difference of DHI score before and after treatment ,between different age, sex, etiology, course and severity of disease reveal is significant, with P<0.01. 【Conclusions】Female can be seen more frequently in BPPV. Primary BPPV present dominantly, and head injury is the most common in secondary BPPV. In primary and secondary BPPV, patients with course less than 3 months are predominant, while the number of patients with course more than 12 months in secondary BPPV is larger than in primary BPPV. In patients with BPPV, PSC-BPPV is the most common, the second is HSC-BPPV. The number of right-sided BPPV is larger than the left one. CPM is proved to be an effective treatment for BPPV. DHI score before and after treatment revealed obvious improvement on the quality of daily life including function, affection and physiology after treatment.