Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment.
OBJECTIVE
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).


METHODS
Eighteen months prospective study of 150 consecutive patients with severe TBI referred to an in-patients rehabilitation department.


METHODS
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.


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.
Motin
M
M
Loewenstein Rehabilitation Hospital, Ra'anana, and Tel-Aviv University, Israel.
Keren
O
O
Groswasser
Z
Z
Gordon
C R
CR
D000059:Accidents; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D004244:Dizziness / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D014717:Vertigo / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology