1887
Volume 2017, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Healthcare costs associated with the diagnosis of benign paroxysmal positional vertigo (BPPV) alone approach $2 billion per year in the United States. Post-traumatic BPPV (t-BPPV) is well recognized, and can be managed with simple bedside physical maneuvers. Despite the availability of literature and clear guidelines supporting this approach, physical maneuvers are underutilized. The aim of this study was to explore the reasons for this practice disagreement. A cross-sectional survey of emergency physicians (EP) and non-emergency physicians (Non-EPs) managing head injury patients was conducted. The survey questions were aimed to explore the attitude of these frontline healthcare providers towards the diagnosis and management of t-BPPV in head injury patients. A total of 102 physicians completed the survey. Of them, male physicians constituted 87.2%, and the majority were working as emergency physicians (80.4%). Although nearly three-fourths (72.5%;  = 74) of the participants admitted that it is important to explore the possibility of t-BPPV in patients with head injury, only one-fifth of the participating physicians (20.6%; 21 of 102) confirmed that they would investigate for t-BPPV. A lack of knowledge about t-BPPV in more than half of the study participants (55.9%;  = 57) was the main reason for them not probing the possibility of t-BPPV. To close the gap between available evidence-based guidelines and actual clinical practice, there is a need for raising awareness about this condition. Addressing the training needs of frontline healthcare providers to use physical maneuvers such as Dix–Hallpike (DHM) and canalith repositioning (CRP) maneuvers in the management of t-BPPV is an important step that needs to be taken.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2017.6
2017-05-19
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2017/1/jemtac.2017.6.html?itemId=/content/journals/10.5339/jemtac.2017.6&mimeType=html&fmt=ahah

References

  1. Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS. Imprecision in patient reports of dizziness symptom quality: A cross-sectional study conducted in an acute care setting. Mayo Clin Proc. 2007; 82:11:13291340.
    [Google Scholar]
  2. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H. Epidemiology of benign paroxysmal positional vertigo: A population based study. J Neurol Neurosurg Psychiatry. 2007; 78:7:710715.
    [Google Scholar]
  3. White JA, Coale KD, Catalano PJ, Oas JG. Diagnosis and management of lateral semicircular canal benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2005; 133:2:278284.
    [Google Scholar]
  4. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003; 169:7:681693.
    [Google Scholar]
  5. Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G. Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurotol. 2013; 18:2:8388.
    [Google Scholar]
  6. Epley JM. Human experience with canalith repositioning maneuvers. Ann NY Acad Sci. 2001; 942::179191.
    [Google Scholar]
  7. Wang H, Yu D, Song N, Su K, Yin S. Delayed diagnosis and treatment of benign paroxysmal positional vertigo associated with current practice. Eur Arch Otorhinolaryngol. 2014; 271:2:261264.
    [Google Scholar]
  8. Arshad M, Abbas S, Qureshi IA. Delay in diagnosis and treatment of benign paroxysmal positional vertigo in current practice. J Ayub Med Coll Abbottabad. 2013; 25:1–2:9395.
    [Google Scholar]
  9. Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, Chalian AA, Desmond AL, Earll JM, Fife TD, Fuller DC, Judge JO, Mann NR, Rosenfeld RM, Schuring LT, Steiner RWP, Whitney SL, Haidari J. Clinical practice guideline: Benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2008; 139:5 Suppl 4:S47S81.
    [Google Scholar]
  10. Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ, Hain TC, Herdman S, Morrow MJ, Gronseth GS. Practice parameter: Therapies for benign paroxysmal positional vertigo (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008; 70:22:20672074.
    [Google Scholar]
  11. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8; 12:CD003162. doi: 10.1002/14651858.CD003162.pub3.
    [Google Scholar]
  12. Ahn SK, Jeon SY, Kim JP, Park JJ, Hur DG, Kim DW, Woo S-H, Kwon O-J, Kim J-Y. Clinical characteristics and treatment of benign paroxysmal positional vertigo after traumatic brain injury. J Trauma. 2011; 70:2:442446.
    [Google Scholar]
  13. Katsarkas A. Benign paroxysmal positional vertigo (BPPV): Idiopathic versus post-traumatic. Acta Otolaryngol. 1999; 119:7:745749.
    [Google Scholar]
  14. Gordon CR, Levite R, Joffe V, Gadoth N. Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form? Arch Neurol. 2004; 61:10:15901593.
    [Google Scholar]
  15. Liu H. Presentation and outcome of post-traumatic benign paroxysmal positional vertigo. Acta Otolaryngol. 2012; 132:8:803806.
    [Google Scholar]
  16. Ouchterlony D, Masanic C, Michalak A, Topolovec-Vranic J, Rutka JA. Treating benign paroxysmal positional vertigo in the patient with traumatic brain injury: Effectiveness of the canalith repositioning procedure. J Neurosci Nurs. 2016; 48:2:9099.
    [Google Scholar]
  17. Newman-Toker DE, Camargo CA Jr, Hsieh YH, Pelletier AJ, Edlow JA. Disconnect between charted vestibular diagnoses and emergency department management decisions: A cross-sectional analysis from a nationally representative sample. Acad Emerg Med. 2009; 16:10:970977.
    [Google Scholar]
  18. Bashir K, Alessai GS, Salem WA, Irfan FB, Cameron PA. Physical maneuvers: Effective but underutilized treatment of benign paroxysmal positional vertigo in the ED. Am J Emerg Med. 2014; 32:1:9596.
    [Google Scholar]
  19. Kerber KA. Benign paroxysmal positional vertigo: Opportunities squandered. Ann NY Acad Sci. 2015; 1343::106112.
    [Google Scholar]
  20. Polensek SH, Tusa RJ, Sterk CE. The challenges of managing vestibular disorders: A qualitative study of clinicians' experiences associated with low referral rates for vestibular rehabilitation. Int J Clin Pract. 2009; 63:11:16041612.
    [Google Scholar]
  21. Baloh RW, Honrubia V, Jacobson K. Benign positional vertigo: Clinical and oculographic features in 240 cases. Neurology. 1987; 37:3:371378.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2017.6
Loading
  • Article Type: Research Article
Keyword(s): BPPVcanalith repositioning maneuverDix–Hallpike maneuveremergency physicians and trauma
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error