Comparision of Video Head Impulse Test Findings Before and After Therapy
Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo
Purpose: Vestibuloocular reflex (VOR) may be helpful in the diagnosis of
Benign Paroxysmal Positional Vertigo (BPPV). Video Head Impulse Test
(vHIT) can effectively diagnose VOR deficits in vestibular disorders.
Aims: The aim of this study is to investigate the significance of vHIT
in determining the efficacy of therapeutic maneuvers in individuals with
posterior semicircular canal BPPV. Materials and Methods: The study
included 25 patients with posterior SCC BPPV (Study Group) between the
ages of 19-65 years, 30 healthy individuals (Control Group). All
individuals underwent otorhinolaryngologic examination, audiological
evaluation with, videonystagmography and vHIT. The Dizziness Handicap
Inventory (DHI) and Visual Analogue Scale (VAS) were administered to the
individuals with posterior SCC BPPV for the intensity of dizziness and
Modified Epley maneuver was performed 3 times at an interval of 3 days.
The vHIT, DHI and VAS were re-administered to these individuals 1 week
after improvement was detected in positional nystagmus. Results: There
was no significant difference between the study and control groups in
terms of vHIT gains for all bilateral SCCs before therapeutic maneuver
(p>0.05). In the study group, there was no significant
difference between vHIT gains of all bilateral SSCs before and after
therapeutic maneuvers (p>0.05). No asymmetry or refixation
saccades (overt and covert) were observed in any of the individuals in
both groups during all measurements. Compared to before therapeutic
maneuvers, there was a significant decrease in dizziness-related
disability level assessed by DHI and intensity of dizziness assessed by
VAS in the study group after the improvement (p<0.001).
Conclusion: It was found that vHIT was not a diagnostic test in BPPV and
in terms of evaluating the efficacy of therapeutic maneuvers. Subjective
evaluations determining the intensity of dizziness and level of
dizziness-related disability in BPPV provided supportive information in
diagnosis and in determining the efficacy of therapeutic maneuvers.