Source
Loewenstein Rehabilitation Hospital, Ra'anana, and Tel-Aviv University, Israel.
Abstract
OBJECTIVES:
To identify patients with benign paroxysmal positional vertigo (BPPV) among patients with severe traumatic brain injury (TBI) and to evaluate the effectiveness of the Particle Repositioning Maneouvre (PRM).
DESIGN AND METHODS:
Eighteen months prospective study of 150 consecutive patients with severe TBI referred to an in-patients rehabilitation department.
INTERVENTIONS:
A structured interview emphasizing the possible presence of vertigo followed by a detailed neuro-otological examination. Patients diagnosed with BPPV were immediately treated with the PRM.
MAIN OUTCOMES AND RESULTS:
BPPV diagnosis was based on a positive Dix-Hallpike positional test. PRM efficacy was determined by repeating the positional test 1 or 2 weeks after treatment. Twenty out of 150 (13.3%) patients complained about positional vertigo. The diagnosis of BPPV was confirmed in 10 patients. Signs and symptoms were completely relieved in six patients after a single PRM, while the other four patients needed repeated treatment for complete resolution of BPPV.
CONCLUSIONS:
About half of the patients with severe TBI who complain about positional vertigo suffer from BPPV. These patients can be efficiently treated by physical maneouvres improving the rehabilitation outcome.