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Sleep position and laterality of benign paroxysmal positional vertigo

  • S G Korres (a1), C E Papadakis (a2), M G Riga (a1), D G Balatsouras (a3), D G Dikeos (a4) and C R Soldatos (a4)...
Abstract</title><sec id='sec1'><title>Objective:</title><p>The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.</p></sec><sec id='sec2'><title>Study design:</title><p>We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix–Hallpike test.</p></sec><sec id='sec3'><title>Methods:</title><p>One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.</p></sec><sec id='sec4'><title>Results:</title><p>The Dix–Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (<span class='italic'>p</span> &lt; 0.001).</p></sec><sec id='sec5'><title>Conclusions:
AbstractObjective:

The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.

Study design:

We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix–Hallpike test.

Methods:

One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.

Results:

The Dix–Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).

Conclusions:

Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.

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Corresponding author
Address for correspondence: Dr Maria Riga, 35 Leoforos Makris, Nea Chili, 68100, Alexandroupolis, Greece. Fax: 0030 2551039986 E-mail: mariariga@hotmail.com
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4 SG Korres , DG Balatsouras . Diagnostic, pathophysiologic, and therapeutic aspects of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2004;131:438–44

5 DS Haynes , JR Resser , RF Labadie , CR Girasole , BT Kovach , LE Scheker Treatment of benign positional vertigo using the Semont maneuver: efficacy in patients presenting without nystagmus. Laryngoscope 2002;112:796801

6 A Katsarkas . Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic. Acta Otolaryngol 1999;119:745–9

7 S Korres , DG Balatsouras , A Kamberos , C Economou , D Kandiloros , E Ferekidis . Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 2002;23:926–32

8 G Serafini , AM Palmieri , C Simincelli . Benign paroxysmal positional vertigo of posterior semicircular canal: results in 160 cases treated with Semont's maneuver. Ann Otol Rhinol Laryngol 1996;105:770–5

9 JS Wolf , KP Boyev , J Manokey , DE Mattox . Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo. Laryngoscope 1999;109:900–3

12 JA Lopez-Escamez , MJ Gamiz , MG Finana , AF Perez , IS Canet . Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol 2002;23:263–6

14 RA Roberts , RE Gans , AH Kastner . Differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Int J Audiol 2006;45:224–6

15 GJ Beynon . A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvers. Br J Audiol 1997;31:1126

16 AM Bronstein . Vestibular reflexes and positional maneuvers. J Neurol Neurosurg Psychiatry 2003;74:289–93

18 JM Epley . Positional vertigo related to semicircular canalithiasis. Otolaryngol Head Neck Surg 1995;112:154–61

19 A Ishiyama , KM Jacobson , RW Baloh . Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol 2000;109:377–80

21 K Gyo . Benign paroxysmal positional vertigo as a complication of postoperative bed-rest. Laryngoscope 1988;98:332–3

22 M von Brevern , T Seelig , H Neuhauser , T Lempert . Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry 2004;75:1487–8

24 S Korres , DG Balatsouras , E Ferekidis . Electronystagmographic findings in benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 2004;113:313–18

25 TM Squires , MS Weidman , TC Hain , HA Stone . A mathematical model for top-shelf vertigo: the role of sedimenting otoconia in BPPV. J Biomech 2004;37:1137–46

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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