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Negative impact of vestibular suppressant drugs on provocative positional tests of BPPV: A study from the Western Part of India
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2021-05-01 , DOI: 10.4103/aian.aian_413_20 Jayanti K Gurumukhani 1 , Dhruvkumar M Patel 2 , Sudhir V Shah 3 , Mukundkumar V Patel 4 , Maitri M Patel 5 , Anand V Patel 6
Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30–4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2–197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients.
Study Design: Prospective case-control observational study.
中文翻译：
前庭抑制药物对 BPPV 刺激性体位测试的负面影响：印度西部的一项研究
目的：研究前庭抑制药物（VSD）对良性阵发性位置性眩晕（BPPV）患者刺激性体位试验（PPT）的影响。设置和设计：一项前瞻性病例对照观察研究。材料和方法：对有 BPPV 病史的患者进行 PPT 检测。PPT上有眩晕症状和眼球震颤的患者被归类为客观BPPV（O-BPPV，对照组），而没有眼震且没有其他诊断的患者被归类为主观BPPV（S-BPPV，病例组）。所有患者均记录了 VSD 治疗的细节。在两组中，患者都被指示停止 VSD，并被进一步分配为 VSD 和非 VSD 亚组。每周用 PPT 对患者进行 2 个月的随访。PPT阳性患者接受前庭康复训练。统计：使用双尾非配对学生 t 检验进行连续量表和卡方检验，以检测两组之间的分类差异。结果：295 名连续 BPPV 患者被纳入研究，其中 S-BPPV 组 55 名，O-BPPV 组 240 名。S-BPPV 组患者在就诊时使用 VSD 的比例明显更高，分别为 80.00% 和 53.75%（OR 2.52；95% CI：1.30-4.86），P = 0.006。在对 S-BPPV 组停用 VSD 后的未经调整的分析中，PPT 在 79.54% 的患者中变为阳性，而在非 VSD 组中为 18.19%（OR 35.0；95% CI：6.2-197.3），P < 0.001 . 结论：在初次就诊时，与 O-BPPV 相比，更高比例的 S-BPPV 患者接受 VSD。在 S-BPPV 患者中停止 VSD 后，PPT 转化为阳性四倍。
研究设计：前瞻性病例对照观察研究。
更新日期：2021-05-01
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2021-05-01 , DOI: 10.4103/aian.aian_413_20 Jayanti K Gurumukhani 1 , Dhruvkumar M Patel 2 , Sudhir V Shah 3 , Mukundkumar V Patel 4 , Maitri M Patel 5 , Anand V Patel 6
Affiliation
Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30–4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2–197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients.
Study Design: Prospective case-control observational study.
中文翻译：
前庭抑制药物对 BPPV 刺激性体位测试的负面影响：印度西部的一项研究
目的：研究前庭抑制药物（VSD）对良性阵发性位置性眩晕（BPPV）患者刺激性体位试验（PPT）的影响。设置和设计：一项前瞻性病例对照观察研究。材料和方法：对有 BPPV 病史的患者进行 PPT 检测。PPT上有眩晕症状和眼球震颤的患者被归类为客观BPPV（O-BPPV，对照组），而没有眼震且没有其他诊断的患者被归类为主观BPPV（S-BPPV，病例组）。所有患者均记录了 VSD 治疗的细节。在两组中，患者都被指示停止 VSD，并被进一步分配为 VSD 和非 VSD 亚组。每周用 PPT 对患者进行 2 个月的随访。PPT阳性患者接受前庭康复训练。统计：使用双尾非配对学生 t 检验进行连续量表和卡方检验，以检测两组之间的分类差异。结果：295 名连续 BPPV 患者被纳入研究，其中 S-BPPV 组 55 名，O-BPPV 组 240 名。S-BPPV 组患者在就诊时使用 VSD 的比例明显更高，分别为 80.00% 和 53.75%（OR 2.52；95% CI：1.30-4.86），P = 0.006。在对 S-BPPV 组停用 VSD 后的未经调整的分析中，PPT 在 79.54% 的患者中变为阳性，而在非 VSD 组中为 18.19%（OR 35.0；95% CI：6.2-197.3），P < 0.001 . 结论：在初次就诊时，与 O-BPPV 相比，更高比例的 S-BPPV 患者接受 VSD。在 S-BPPV 患者中停止 VSD 后，PPT 转化为阳性四倍。
研究设计：前瞻性病例对照观察研究。
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