Analysis Of Clinical Features And Risk Factors Of Residual Dizziness Of Benign Paroxysmal Positional Vertigo After Successful Canalith Repositioning Procedure

ObjectiveIn order to study the clinical characteristics and possible risk factors of residual dizziness in patients with BPPV after successful reduction,we compared the baseline characteristics with RD group and non-RD group,as well as HADS and DHI scores before and after CRP.MethodsThis study summarized and analyzed the clinical data of 123 patients diagnosed with BPPV and successful manual reduction in the First Affiliated Hospital of Nanchang University.The patients were divided into RD group and non-RD group according to the presence or absence of residual symptoms.Baseline data,clinical characteristics,HADS and DHI score before and after reduction were collected from all patients,as well as main clinical manifestations and duration of RD group.Statistical analysis was performed to determine the clinical characteristics of residual dizziness,RD and the influencing factors of RD duration.Results1.Among 123 BPPV patients with successful manual reduction,41%(51/123)had residual dizziness and were included in the RD group.Among the 51 patients,14cases(27.45%)had light-headed feet,6 cases(11.77%)had walking instability,and31 cases(60.78%)had combined the above two symptoms.88.23% cases(45/51)were induced by persistent dizziness and 11.77%(6/51)were relevent to changing of body position.2.Paired-sample t-test was performed to compare DHI scores before and after reduction between the two groups.The average score of RD group was68.08±20.70 points before reduction and 29.63±16.94 points after reduction.In the non-RD group,the scores after reduction were significantly lower than those before reduction,averaging 59.33±22.62 points and 2.89±3.94 points.The difference was statistically significant(P<0.01).3.Univariate regression analysis showed that the incidence of RD was not related to the type of attack,semicircular canal,side and gender(P>0.05).Past-history of BPPV(P<0.05),combined hypertension and/or diabetes(P<0.05),age(P<0.05),duration of vertigo before reduction(P<0.05),DHI score before reduction(P=0.03<0.05),HADS score(P=0.03<0.05)may be associated with occurrence of RD after successful CRP.Multivariate regression analysis showed that older age,long course of disease,past-history of BPPV,combined with hypertension and/or diabetes were independent risk factors for RD.4.There was no significant correlation between appearance of RD and factors(P>0.05),like gender,age,attack type,side,semicircular canal,past-history of BPPV,complication of hypertension and/or diabetes,dizziness duration before reduction.Conclusion1.CRP can effectively relieve the symptoms of patients with BPPV regardless of residual dizziness.2.Past-history of BPPV,the aged,complicated hypertension and/or diabetes,and long duration of dizziness before reduction were independent risk factors for residual dizziness.The occurrence of RD was not related to gender,attack type,side,and semicircular canal.3.There was no significant correlation between prognosis of RD and following reasons,like gender,age,sex,attack type,lateral type,semicircular canal,history of BPPV,complication of hypertension or diabetes,dizziness duration before reduction.4.For BPPV patients who have received CRP successfully,RD can be evaluated according to the patient’s history and clinical characteristics,and corresponding treatment can be given.