Abstract
With the exception of migraines,
benign paroxysmal positional vertigo (BPPV) in patients with preexisting
central neurologic disorders (CND) is rarely discussed in the literature.
Demographic features of this patient group and the efficacy of repositioning
therapy are still unknown. We hypothesized that a CND may alter the function of
the central vestibular pathway, thus changing the pattern of BPPV and outcomes
of repositioning. In this study, we enrolled 93 consecutive idiopathic BPPV
patients and categorized them into two groups according to the presence or
absence of a CND. In our series, 31.2% of BPPV cases had a CND. The most common
associated CNDs were cerebrovascular disease and migraines. The two groups
showed similar age distributions, canal involvement, success rates of
repositioning, and cycles of treatment used to achieve complete resolution. The
major differences were the proportion of females (89.7%) and a right-side
predominance (75.9%) in the CND group. There was a trend of more residual dizziness
(RD) after successful repositioning in the CND group, but the difference was
not significant. The reason for the female and right-side predominance in the
CND group is unclear. We concluded that the efficacy of repositioning therapy
was excellent (with a success rate of 80.6% with one cycle and 93.5% within two
cycles of treatment) for BPPV with or without a preexisting CND. Clinicians are
encouraged to diagnose and treat BPPV in patients with a preexisting CND as
early as possible to improve patients' quality of life, avoid complications,
and reduce medical costs.