Autonomic dysfunction as a possible cause of residual dizziness
after successful treatment in benign paroxysmal positional vertigo
- Hyun-Ah Kim; Hyung Lee
- Publication Year
- Objective: To investigate whether residual dizziness after successful treatment in patients with benign
paroxysmal positional vertigo (BPPV) was associated with autonomic dysfunction.
Methods: Fifty-eight consecutive patients with BPPV who had successful canal repositioning procedures
(CRPs) and showed no nystagmus or positional vertigo at the next follow-up visit were enrolled and
divided into two groups with and without residual dizziness. We performed a standardized autonomic
Results: Of the 58 patients, 25 (43%) complained of residual dizziness after successful CRPs, in which postural
lightheadedness when righting from sitting, or short-lasting nonspecific dizziness that occurred
during head movement or walking were common complaints. Orthostatic hypotension (OH) occurred
in 11 patients (19%). Incidence of OH was significantly higher in patients with residual dizziness at the
next follow-up than those without residual dizziness (40% and 3%, p = 0.000). Compared to patients without
residual dizziness, patients with residual dizziness had larger falls in systolic BP during the valsalva
maneuver and head-up tilt test. However, cardiovagal parasympathetic function was not different
between the patients with and without residual dizziness.
Conclusion: In BPPV, residual dizziness after successful treatment may be associated with sympathoneural
Significance: This investigation could be useful in understanding the mechanism of residual dizziness in
patients with BPPV.
2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights
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