title: Approach to benign paroxysmal positional vertigo in old age.
abstract: BACKGROUND
  Benign paroxysmal positional vertigo is a common and treatable vestibular disorder characterized by attacks of positional vertigo. Although elderly patients often complain about unsteadiness, the symptom of positional vertigo is seldom reported. Several studies on BPPV in the elderly reveal a low success rate in the treatment of this entity.
  
  
  OBJECTIVE
  To assess the clinical characteristics and treatment outcome of BPPV in elderly patients and to compare them with those of the general population treated at our dizziness clinic.
  
  
  METHODS
  We reviewed the medical records of 23 patients above age 75 who were treated at our dizziness clinic for BPPV during the years 1998-2004. Their clinical data, BPPV characteristics and treatment outcome were compared with the data of 30 consecutive BPPV patients who represented the general population.
  
  
  RESULTS
  No differences in gender distribution, duration of BPPV, treatment responsiveness or recurrence rate were found between elderly patients as compared to the general population. The duration of the last attack of positional vertigo was found to be longer in the elderly, probably due to the delay in recognition of symptoms and accessibility of a dizziness clinic.
  
  
  CONCLUSIONS
  Our study shows that BPPV characteristics and treatment effectiveness, as measured by negative Dix-Hallpike maneuver, are not age-dependent and there is no need for a special approach or cautiousness in prognosis prediction. It is important to search actively for this condition since treatment leads to amelioration of unsteadiness and improved well-being in these patients.
authors: Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel. lpollak@asaf.health.gov.il
authors: Pollak
authors: P
authors: Lea
authors: Mark
authors: M
authors: Kushnir
authors: Yizchak
authors: Y
authors: Shpirer
authors: Yaacov
authors: Y
authors: Zomer
authors: Shlomo
authors: S
authors: Flechter
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004244:Dizziness / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009760:Nystagmus, Physiologic; D026741:Physical Therapy Modalities; D011187:Posture; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*