title: Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?
abstract: OBJECTIVE
  The aim of the study was to evaluate the true incidence, diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV) arising after whiplash injury and to distinguish this type of posttraumatic vertigo from other types of dizziness complained after trauma.
  
  
  METHODS
  This was a retrospective study comprising patients referred to our center after whiplash injury. The patients were evaluated with neurotologic examination including bedside and instrumental tests. A Dizziness Handicap Inventory evaluating the symptoms of patients was submitted before and after treatment and was evaluated. The BPPV patients were separately evaluated from those with cervicogenic vertigo, and a comparison between our data about idiopathic BPPV was done.
  
  
  RESULTS
  Eighteen patients of whiplash who had BPPV were evaluated. The mean age was 38.2 years. BPPV was the cause of vertigo in 33.9% of total whiplash patients. In 16 cases, the posterior semicircular canal was involved; the lateral semicircular canal was involved in 2 cases. The instrumental neurotologic assessment did not show any alteration of either vestibulospinal reflexes or dynamic ocular movements. Duration of symptoms before treatment ranged from 3 to 26 days. A total of 55.5% of patients had relief from their symptoms after first repositioning maneuver. The Dizziness Handicap Inventory score improved in all patients treated with repositioning maneuvers, but no difference emerged with idiopathic BPPV data.
  
  
  CONCLUSIONS
  BPPV after whiplash injury could be unveiled with a simple bedside examination of peripheral vestibular system, and a treatment could be done in the same session. The diagnosis of posttraumatic BPPV is not different from the idiopathic form, but the treatment may require more maneuvers to achieve satisfactory results.
authors.affiliation: Dipartimento Discipline Chirurgiche ed Oncologiche-UO Otorinolaringoiatria, Università degli Studi di Palermo, Italia. francesco.dispenza@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Dispenza
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Stefano
authors.forename: Navneet
authors.initials: N
authors.lastname: Mathur
authors.forename: Adelchi
authors.initials: A
authors.lastname: Croce
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gallina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009760:Nystagmus, Physiologic / Q000502:physiology*; D056888:Patient Positioning; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000503:physiopathology; D015599:Trauma Severity Indices; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014911:Whiplash Injuries / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D055815:Young Adult