title: [Benign paroxysmal positional vertigo with and without manifest positional nystagmus: an 18-month follow-up study of 70 patients].
abstract: BACKGROUND
  In this follow-up study of approximately 18 months we assessed parameters of medical management in a sample of 70 patients suffering from benign paroxysmal positional vertigo.
  
  
  METHODS
  Apart from demographic data, we evaluated the time interval from the appearance of the first symptoms until a diagnostic positional manoeuvre was performed, the efficacy of liberatory manoeuvres, the prescription of medication, the use of technical diagnostic resources and the relapse rate.
  
  
  RESULTS
  None of the patients had received a diagnostic positioning test until then. Moreover, in one out of three cases a further unnecessary technical diagnostic procedure was carried out. There was a tendency for the right labyrinth to be more frequently affected, a fact that was statistically independent from age and sex, as well as from overall prognosis, which was characterized by a 15.6% recurrence rate. All patients with manifest positional nystagmus were successfully treated: 87.2% immediately after the repositioning manoeuvre and the rest within 10 days by self-performing Brandt-Daroff exercises. Our retrospective analysis revealed that, given a normal neuro-otological examination, a typical medical history without manifest positioning nystagmus leads safely to the correct diagnosis.
  
  
  CONCLUSIONS
  The delay between the onset of symptoms and the diagnosis of BPPV is very often unduly long. A focused medical history may be diagnostic even in the absence of nystagmus during the Dix-Hallpike manoeuvre.
authors.affiliation: Department of Physiology, Faculty of Health Sciences, School of Nursing, University of Athens, Greece. danastas@nurs.uoa.gr
authors.forename: E
authors.initials: E
authors.lastname: Anagnostou
authors.forename: D
authors.initials: D
authors.lastname: Mandellos
authors.forename: A
authors.initials: A
authors.lastname: Patelarou
authors.forename: D
authors.initials: D
authors.lastname: Anastasopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000150:complications* / Q000175:diagnosis*; D009760:Nystagmus, Physiologic; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014717:Vertigo / Q000150:complications* / Q000175:diagnosis*; D014724:Vestibular Function Tests / Q000379:methods*