Clinical Aspects of Patients With Benign Paroxysmal Positional Vertigo (BPPV) and Migraine

Study Overview
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Brief Summary
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The aim of this study is to analyze the clinical aspects of patients with BPPV associated with migraine. It is our purpose to clarify weather migraine is a risk factor for BPPV if the clinical aspect and the therapeutic outcome is different.

Detailed Description
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Two hundred and sixty-three patients with BPPV were enrolled in this retrospective study. All patients' charts were reviewed by independent observer. The type of BPPV and associated problems were noted. Patients with migraine were investigated in terms of age, gender, symptoms, affected side and the cure rate. Their data were compared with those having no migraine. Mean values and standard deviations (± SD) were calculated. One way ANOVA test was used for the analysis. Significance was set at p < 0.005.

Official Title
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Clinical Aspects of Patients With Benign Paroxysmal Positional Vertigo (BPPV) and Migraine

Conditions
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Migraine, Positional Vertigo

Intervention / Treatment
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* Procedure: Particle re-positioning maneuver


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who had history of head-induced positional and brief vertigo and who have been confirmed by VNG were included Exclusion Criteria: Patients with balance problem other than BPPV, Patients receiving any medication prior to therapeutic maneuver were excluded

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 84 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| BPPV without migraine<br>Two hundred and sixty-three patients with BPPV (2009-2014), confirmed by videonystagmography (VNG), were enrolled in the study. Patients' charts were reviewed. They were grouped as those with or without migraine. Distribution of gender, age, duration of symptoms and affected side were reviewed. Two hundred and thirty-one patients with no migraine were identified. | Procedure: Particle re-positioning maneuver<br>* Patients with posterior canal BPPV (PC-BPPV) were treated with Epley maneuver. Patients with superior canal (SC-BPPV) were treated with Li or reverse Epley maneuver. Patients with lateral canal (LC) apogeotropic or geotropic nystagmus were treated with Barbeque, Semont's or Gufoni maneuvers. If geotropic or ageotropic type nystagmus is equal intensity on both sides. The involved side was determined according to the patient sense of disturbance or lying down positioning test. If the patient has involvement of both sides according to Dix-Hallpike maneuver. Therapeutic maneuver was applied to the more severe side. All patients were re-evaluated at maximum 7 days.<br>|
| BPPV with migraine<br>Thirty-two patients (11.4%) with migraine were identified. Diagnosis and classification of migraine and its differentiation from other type of headaches was based on third edition of International classification of headache disorders (ICHD-III beta) by international headache society (IHS). All patients with migraine had migrainous headache with or without aura and they all were diagnosed in our institution and followed by our neurology staff. | Procedure: Particle re-positioning maneuver<br>* Patients with posterior canal BPPV (PC-BPPV) were treated with Epley maneuver. Patients with superior canal (SC-BPPV) were treated with Li or reverse Epley maneuver. Patients with lateral canal (LC) apogeotropic or geotropic nystagmus were treated with Barbeque, Semont's or Gufoni maneuvers. If geotropic or ageotropic type nystagmus is equal intensity on both sides. The involved side was determined according to the patient sense of disturbance or lying down positioning test. If the patient has involvement of both sides according to Dix-Hallpike maneuver. Therapeutic maneuver was applied to the more severe side. All patients were re-evaluated at maximum 7 days.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients who had normal vestibular response to provocative tests 7 days after re-positioning maneuver | Every patient with BPPV who had positional nystagmus during Dix-Hallpike and head-roll provocative maneuvers will be treated with Epley or barbeque particle re-positioning maneuvers. Balance (positional nystagmus) of patients 7 days after re-positioning maneuvers will be assessed. | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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migraine, benign paroxysmal positional vertigo