title: Comparison between objective and subjective benign paroxysmal positional vertigo: clinical features and outcomes.
abstract: CONCLUSIONS
  Objective benign paroxysmal positional vertigo (O-BPPV) and subjective BPPV (S-BPPV) have similar demographic and clinical features. Canalith repositioning manoeuvres (CRMs) can be an effective treatment for patients with S-BPPV, and a diagnosis of positional nystagmus is not essential for considering CRMs. This study supports the use of CRMs as the primary treatment for S-BPPV.
  
  
  OBJECTIVE
  To examine differences in demographic and clinical features, as well as treatment outcomes, between O-BPPV and S-BPPV.
  
  
  METHODS
  The medical records of 134 patients with BPPV were reviewed for demographic characteristics, past medical history, associated symptoms, response to CRMs, interval between symptom onset and the first medical visit, and recurrence rate. The O-BPPV group (n = 101) comprised patients who experienced vertigo and accompanying autonomic symptoms, and showed typical nystagmus. The S-BPPV group (n = 33) comprised patients who, when subjected to a provoking manoeuvre, showed all of the classic BPPV symptoms but did not show nystagmus. All patients had at least 3 years of follow-up.
  
  
  RESULTS
  The demographics (age and sex ratio), past medical history, and associated symptoms were not significantly different between the two groups. Posterior semi-circular canal BPPV appeared more than twice as often as horizontal semi-circular canal BPPV in patients with S-BPPV. However, both canals were affected to a similar proportion in patients with O-BPPV, and the difference was marginally significant (p = 0.073). Overall improvement was better in O-BPPV than in S-BPPV; however, there was no significant difference. The total numbers of manoeuvres for recovery and the interval between symptom onset and the first medical visit also did not show any significant inter-group differences. During a 3-year follow-up, the recurrence rate was 13.8% for O-BPPV and 21.2% for S-BPPV.
authors.affiliation: a Department of Otolaryngology-Head & Neck Surgery , Dankook University Hospital , Cheonan , Republic of Korea.
authors.forename: Jae Yun
authors.initials: JY
authors.lastname: Jung
authors.affiliation: b Department of Otorhinolaryngology-Head and Neck Surgery , Jeju National University School of Medicine , Jeju , Republic of Korea.
authors.forename: Se-Hyung
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Benign paroxysmal positional vertigo; canalolithiasis; nystagmus; repositioning manoeuvre