Our experience with 500 patients with benign paroxysmal positional vertigo: Reexploring aetiology and reevaluating MRI investigation.
Identifieur interne : 000100 ( Main/Corpus ); précédent : 000099; suivant : 000101Our experience with 500 patients with benign paroxysmal positional vertigo: Reexploring aetiology and reevaluating MRI investigation.
Auteurs : Fei Tan ; Constantin Bartels ; Rory Mcconn WalshSource :
- Auris, nasus, larynx [ 1879-1476 ] ; 2018.
English descriptors
- KwdEn :
- Acute Disease (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Benign Paroxysmal Positional Vertigo (diagnostic imaging), Benign Paroxysmal Positional Vertigo (etiology), Benign Paroxysmal Positional Vertigo (therapy), Brain Neoplasms (complications), Brain Neoplasms (diagnostic imaging), Craniocerebral Trauma (complications), Female (MeSH), Humans (MeSH), Incidental Findings (MeSH), Intracranial Hemorrhages (complications), Intracranial Hemorrhages (diagnostic imaging), Labyrinthitis (complications), Magnetic Resonance Imaging (MeSH), Male (MeSH), Middle Aged (MeSH), Nasal Surgical Procedures (MeSH), Neck Injuries (complications), Otologic Surgical Procedures (MeSH), Patient Positioning (methods), Postoperative Complications (diagnostic imaging), Postoperative Complications (etiology), Retrospective Studies (MeSH), Young Adult (MeSH).
- MESH :
- complications : Brain Neoplasms, Craniocerebral Trauma, Intracranial Hemorrhages, Labyrinthitis, Neck Injuries.
- diagnostic imaging : Benign Paroxysmal Positional Vertigo, Brain Neoplasms, Intracranial Hemorrhages, Postoperative Complications.
- etiology : Benign Paroxysmal Positional Vertigo, Postoperative Complications.
- methods : Patient Positioning.
- therapy : Benign Paroxysmal Positional Vertigo.
- Acute Disease, Adult, Aged, Aged, 80 and over, Female, Humans, Incidental Findings, Magnetic Resonance Imaging, Male, Middle Aged, Nasal Surgical Procedures, Otologic Surgical Procedures, Retrospective Studies, Young Adult.
Abstract
OBJECTIVE
To explore the aetiology of and to evaluate the importance of MRI investigation on the posterior semicircular canal benign paroxysmal positional vertigo in an Irish population.
METHODS
A retrospective observational study of 500 patients with posterior semicircular canal benign paroxysmal positional vertigo, diagnosed and treated by the senior author over a 10-year period. Most patients underwent an MRI brain and inner ear, following the same scan protocol. This included T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2 weighted and FLAIR sequences plus time of flight cerebral angiography.
RESULTS
The average age of presentation was 56 years; with the overall female to male ratio was 1.6:1, which was largely the net results of 2 age groups. Over 30% of our patients recalled distinct aetiological triggers, of which the top 3 were trauma, infection, and surgery. These accounted for 16%, 6%, and 5%, respectively. More than 25% of the patients were discovered to have abnormal intracranial findings on MRI. The 2 most common non-infarct incidental findings were neoplasia and vascular abnormalities. Although fewer than 20 patients had acute intracranial haemorrhage or malignant tumours, most of them were urgently referred to neurosurgeon due to the life-threatening nature of the condition. One round of particle repositioning manoeuver was successful in treating 84% of the patients, and the 2-year recurrence rate was only 2.2%.
CONCLUSION
The diagnosis of posterior semicircular canal benign paroxysmal positional vertigo is thought to be relatively easy to make, and the treatment is highly effective. Clinicians should be fully aware of and prepared for the diverse aetiology, and thus have no hesitation in requesting MRI scan as an important investigation.
DOI: 10.1016/j.anl.2017.05.017
PubMed: 28943053
Links to Exploration step
pubmed:28943053Le document en format XML
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Electronic address: iatrologist@hotmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Bartels, Constantin" sort="Bartels, Constantin" uniqKey="Bartels C" first="Constantin" last="Bartels">Constantin Bartels</name><affiliation><nlm:affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Waterford Regional Hospital, Waterford, Ireland.</nlm:affiliation></affiliation></author><author><name sortKey="Walsh, Rory Mcconn" sort="Walsh, Rory Mcconn" uniqKey="Walsh R" first="Rory Mcconn" last="Walsh">Rory Mcconn Walsh</name><affiliation><nlm:affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Beaumont Hospital and Blackrock Clinic, Dublin, Ireland.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2018">2018</date><idno type="RBID">pubmed:28943053</idno><idno type="pmid">28943053</idno><idno type="doi">10.1016/j.anl.2017.05.017</idno><idno type="wicri:Area/Main/Corpus">000100</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000100</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Our experience with 500 patients with benign paroxysmal positional vertigo: Reexploring aetiology and reevaluating MRI investigation.</title><author><name sortKey="Tan, Fei" sort="Tan, Fei" uniqKey="Tan F" first="Fei" last="Tan">Fei Tan</name><affiliation><nlm:affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, St. James's Hospital, Dublin 8, Ireland. Electronic address: iatrologist@hotmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Bartels, Constantin" sort="Bartels, Constantin" uniqKey="Bartels C" first="Constantin" last="Bartels">Constantin Bartels</name><affiliation><nlm:affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Waterford Regional Hospital, Waterford, Ireland.</nlm:affiliation></affiliation></author><author><name sortKey="Walsh, Rory Mcconn" sort="Walsh, Rory Mcconn" uniqKey="Walsh R" first="Rory Mcconn" last="Walsh">Rory Mcconn Walsh</name><affiliation><nlm:affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Beaumont Hospital and Blackrock Clinic, Dublin, Ireland.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Auris, nasus, larynx</title><idno type="eISSN">1879-1476</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Disease (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Benign Paroxysmal Positional Vertigo (diagnostic imaging)</term><term>Benign Paroxysmal Positional Vertigo (etiology)</term><term>Benign Paroxysmal Positional Vertigo (therapy)</term><term>Brain Neoplasms (complications)</term><term>Brain Neoplasms (diagnostic imaging)</term><term>Craniocerebral Trauma (complications)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Incidental Findings (MeSH)</term><term>Intracranial Hemorrhages (complications)</term><term>Intracranial Hemorrhages (diagnostic imaging)</term><term>Labyrinthitis (complications)</term><term>Magnetic Resonance Imaging (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Nasal Surgical Procedures (MeSH)</term><term>Neck Injuries (complications)</term><term>Otologic Surgical Procedures (MeSH)</term><term>Patient Positioning (methods)</term><term>Postoperative Complications (diagnostic imaging)</term><term>Postoperative Complications (etiology)</term><term>Retrospective Studies (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Brain Neoplasms</term><term>Craniocerebral Trauma</term><term>Intracranial Hemorrhages</term><term>Labyrinthitis</term><term>Neck Injuries</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term><term>Brain Neoplasms</term><term>Intracranial Hemorrhages</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Patient Positioning</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Acute Disease</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Incidental Findings</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Nasal Surgical Procedures</term><term>Otologic Surgical Procedures</term><term>Retrospective Studies</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To explore the aetiology of and to evaluate the importance of MRI investigation on the posterior semicircular canal benign paroxysmal positional vertigo in an Irish population.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A retrospective observational study of 500 patients with posterior semicircular canal benign paroxysmal positional vertigo, diagnosed and treated by the senior author over a 10-year period. Most patients underwent an MRI brain and inner ear, following the same scan protocol. This included T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2 weighted and FLAIR sequences plus time of flight cerebral angiography.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The average age of presentation was 56 years; with the overall female to male ratio was 1.6:1, which was largely the net results of 2 age groups. Over 30% of our patients recalled distinct aetiological triggers, of which the top 3 were trauma, infection, and surgery. These accounted for 16%, 6%, and 5%, respectively. More than 25% of the patients were discovered to have abnormal intracranial findings on MRI. The 2 most common non-infarct incidental findings were neoplasia and vascular abnormalities. Although fewer than 20 patients had acute intracranial haemorrhage or malignant tumours, most of them were urgently referred to neurosurgeon due to the life-threatening nature of the condition. One round of particle repositioning manoeuver was successful in treating 84% of the patients, and the 2-year recurrence rate was only 2.2%.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The diagnosis of posterior semicircular canal benign paroxysmal positional vertigo is thought to be relatively easy to make, and the treatment is highly effective. Clinicians should be fully aware of and prepared for the diverse aetiology, and thus have no hesitation in requesting MRI scan as an important investigation.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28943053</PMID><DateCompleted><Year>2018</Year><Month>10</Month><Day>16</Day></DateCompleted><DateRevised><Year>2018</Year><Month>10</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1476</ISSN><JournalIssue CitedMedium="Internet"><Volume>45</Volume><Issue>2</Issue><PubDate><Year>2018</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Auris, nasus, larynx</Title><ISOAbbreviation>Auris Nasus Larynx</ISOAbbreviation></Journal><ArticleTitle>Our experience with 500 patients with benign paroxysmal positional vertigo: Reexploring aetiology and reevaluating MRI investigation.</ArticleTitle><Pagination><MedlinePgn>248-253</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0385-8146(17)30164-5</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.anl.2017.05.017</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To explore the aetiology of and to evaluate the importance of MRI investigation on the posterior semicircular canal benign paroxysmal positional vertigo in an Irish population.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A retrospective observational study of 500 patients with posterior semicircular canal benign paroxysmal positional vertigo, diagnosed and treated by the senior author over a 10-year period. Most patients underwent an MRI brain and inner ear, following the same scan protocol. This included T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2 weighted and FLAIR sequences plus time of flight cerebral angiography.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The average age of presentation was 56 years; with the overall female to male ratio was 1.6:1, which was largely the net results of 2 age groups. Over 30% of our patients recalled distinct aetiological triggers, of which the top 3 were trauma, infection, and surgery. These accounted for 16%, 6%, and 5%, respectively. More than 25% of the patients were discovered to have abnormal intracranial findings on MRI. The 2 most common non-infarct incidental findings were neoplasia and vascular abnormalities. Although fewer than 20 patients had acute intracranial haemorrhage or malignant tumours, most of them were urgently referred to neurosurgeon due to the life-threatening nature of the condition. One round of particle repositioning manoeuver was successful in treating 84% of the patients, and the 2-year recurrence rate was only 2.2%.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The diagnosis of posterior semicircular canal benign paroxysmal positional vertigo is thought to be relatively easy to make, and the treatment is highly effective. Clinicians should be fully aware of and prepared for the diverse aetiology, and thus have no hesitation in requesting MRI scan as an important investigation.</AbstractText><CopyrightInformation>Copyright © 2018 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tan</LastName><ForeName>Fei</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, St. James's Hospital, Dublin 8, Ireland. Electronic address: iatrologist@hotmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bartels</LastName><ForeName>Constantin</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Waterford Regional Hospital, Waterford, Ireland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walsh</LastName><ForeName>Rory McConn</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Department of Otorhinolaryngology and Head and Neck Surgery, Beaumont Hospital and Blackrock Clinic, Dublin, Ireland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>09</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Auris Nasus Larynx</MedlineTA><NlmUniqueID>7708170</NlmUniqueID><ISSNLinking>0385-8146</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000208" MajorTopicYN="N">Acute Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001932" MajorTopicYN="N">Brain 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MajorTopicYN="N">Labyrinthitis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D059747" MajorTopicYN="N">Nasal Surgical Procedures</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019838" MajorTopicYN="N">Neck Injuries</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013506" MajorTopicYN="N">Otologic Surgical Procedures</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D056888" MajorTopicYN="N">Patient Positioning</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Aetiology</Keyword><Keyword MajorTopicYN="N">Algorithm</Keyword><Keyword MajorTopicYN="N">BPPV</Keyword><Keyword MajorTopicYN="N">Demographics</Keyword><Keyword MajorTopicYN="N">Dix-Hallpike</Keyword><Keyword MajorTopicYN="N">Epley manoeuvre</Keyword><Keyword MajorTopicYN="N">European</Keyword><Keyword MajorTopicYN="N">Incidental finding</Keyword><Keyword MajorTopicYN="N">Infection</Keyword><Keyword MajorTopicYN="N">MRI</Keyword><Keyword MajorTopicYN="N">Scan</Keyword><Keyword MajorTopicYN="N">Semicircular canal</Keyword><Keyword MajorTopicYN="N">Surgery</Keyword><Keyword MajorTopicYN="N">Trauma</Keyword><Keyword MajorTopicYN="N">Tumour</Keyword><Keyword MajorTopicYN="N">Vertigo</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>02</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>05</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>05</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>9</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>10</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>9</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28943053</ArticleId><ArticleId IdType="pii">S0385-8146(17)30164-5</ArticleId><ArticleId IdType="doi">10.1016/j.anl.2017.05.017</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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