Background: Although head trauma is considered a common cause of benign paroxy smal positional vertigo (BPPV), clinical presentation and outcome of traumatic B PPV (t BPPV) have not been systematically evaluated. Obje...Background: Although head trauma is considered a common cause of benign paroxy smal positional vertigo (BPPV), clinical presentation and outcome of traumatic B PPV (t BPPV) have not been systematically evaluated. Objectives: To compare the clinical presentation, patients response to physical treatment, and outcome o f patients with t BPPV with those with the idiopathic form (i BBPV). Setting: Tertiary referral neuro otology outpatient clinic. Methods: We reviewed the cli nical records of 247 consecutive patients with posterior canal BPPV during the y ears 1997 to 2000. All patients were diagnosed using the Dix Hallpike test and treated using the particle repositioning maneuver. Patients with an onset of pos itional vertigo within 3 days of well documented head trauma were included in t he t BPPV group. The outcome was compared with the outcome of 42 patients with i BPPV who were similarly treated and followed up. Results: Twenty one (8.5%) of the 247 patients with BPPV fulfilled the diagnostic criteria for t BPPV. Th e most common cause of head trauma was motor vehicle crash, documented in 57%of the cases; half of the patients additionally suffered from a whiplash injury. W hile the other causes were diverse, common falls were predominant. Only 2 of the patients involved in motor vehicle crashes experienced brief loss of consciousn ess. Sixty seven percent of patients with t BPPV required repeated physical tr eatments for complete resolution of signs and symptoms in comparison to 14%of p atients with i BPPV (P<.0 01). During a mean ±SD follow up of 21.7±9.7 months, 57%of t BPPV patients and 19%of i BPPV controls had recurrent attacks (P<.004). Conclusions: The nat ure and severity of the traumas causing t BPPV are diverse, ranging from minor head injuries to more severe head and neck trauma with brief loss of consciousne ss. It appears that t BPPV is more difficult to treat than i BPPV, and also ha s a greater tendency to recur.展开更多
Background: Despite their high incidence, costs, and long lasting disability, whiplash associated disorders (WAD)- lack an identifiable objective pathology that explains their acute or chronic symptoms. Objective: In ...Background: Despite their high incidence, costs, and long lasting disability, whiplash associated disorders (WAD)- lack an identifiable objective pathology that explains their acute or chronic symptoms. Objective: In view of previous suggestions of a possible effect of neck torsion on several electro- oculography (EOG) parameters, the main objective of this study was to examine their applicability in differentiating patients from uninvolved subjects. Methods: Smooth pursuit and saccadic eye movements were assessed in 26 patients with chronic WAD and 23 healthy subjects. All tests were executed in three neck positions: neutral and rotations to left and right. Results: Neck torsion did not influence eye movement performance of either the WAD or healthy groups. However, compared with the healthy group, patients with WAD had significantly lower smooth pursuit velocity gain (SPVG) (P=0.01)and prolonged saccadic latency (P=0.001), irrespective of neck position. Conclusions: Despite scattered differences that reached significance, the electro- oculographic measures used in this study do not seem to offer a clinically relevant method for differentiating between patients with WAD and normal subjects.展开更多
文摘Background: Although head trauma is considered a common cause of benign paroxy smal positional vertigo (BPPV), clinical presentation and outcome of traumatic B PPV (t BPPV) have not been systematically evaluated. Objectives: To compare the clinical presentation, patients response to physical treatment, and outcome o f patients with t BPPV with those with the idiopathic form (i BBPV). Setting: Tertiary referral neuro otology outpatient clinic. Methods: We reviewed the cli nical records of 247 consecutive patients with posterior canal BPPV during the y ears 1997 to 2000. All patients were diagnosed using the Dix Hallpike test and treated using the particle repositioning maneuver. Patients with an onset of pos itional vertigo within 3 days of well documented head trauma were included in t he t BPPV group. The outcome was compared with the outcome of 42 patients with i BPPV who were similarly treated and followed up. Results: Twenty one (8.5%) of the 247 patients with BPPV fulfilled the diagnostic criteria for t BPPV. Th e most common cause of head trauma was motor vehicle crash, documented in 57%of the cases; half of the patients additionally suffered from a whiplash injury. W hile the other causes were diverse, common falls were predominant. Only 2 of the patients involved in motor vehicle crashes experienced brief loss of consciousn ess. Sixty seven percent of patients with t BPPV required repeated physical tr eatments for complete resolution of signs and symptoms in comparison to 14%of p atients with i BPPV (P<.0 01). During a mean ±SD follow up of 21.7±9.7 months, 57%of t BPPV patients and 19%of i BPPV controls had recurrent attacks (P<.004). Conclusions: The nat ure and severity of the traumas causing t BPPV are diverse, ranging from minor head injuries to more severe head and neck trauma with brief loss of consciousne ss. It appears that t BPPV is more difficult to treat than i BPPV, and also ha s a greater tendency to recur.
文摘Background: Despite their high incidence, costs, and long lasting disability, whiplash associated disorders (WAD)- lack an identifiable objective pathology that explains their acute or chronic symptoms. Objective: In view of previous suggestions of a possible effect of neck torsion on several electro- oculography (EOG) parameters, the main objective of this study was to examine their applicability in differentiating patients from uninvolved subjects. Methods: Smooth pursuit and saccadic eye movements were assessed in 26 patients with chronic WAD and 23 healthy subjects. All tests were executed in three neck positions: neutral and rotations to left and right. Results: Neck torsion did not influence eye movement performance of either the WAD or healthy groups. However, compared with the healthy group, patients with WAD had significantly lower smooth pursuit velocity gain (SPVG) (P=0.01)and prolonged saccadic latency (P=0.001), irrespective of neck position. Conclusions: Despite scattered differences that reached significance, the electro- oculographic measures used in this study do not seem to offer a clinically relevant method for differentiating between patients with WAD and normal subjects.
