Benign paroxysmal positional vertigo and treatment in biaxial rotational chair
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Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral dizziness. The overall aim of this thesis was to examine a new standardised intervention-tool to provide a better treatment for patients with BPPV. BPPV is defined as short attacks of vertigo and nystagmus elicited by certain provocative head positions. BPPV is diagnosed by examination of positional vertigo and evaluation of the characteristics of the positional nystagmus triggered by the diagnostic manoeuvres. The character and direction of the nystagmus are specific to the semicircular canal that is affected. Evaluation of the clinical relevance of nystagmus is important. It is sometimes challenging to differentiate positional nystagmus in the normal population from positional nystagmus seen in BPPV patients. Our study showed that positional nystagmus is common in the normal population, but that it is different from positional nystagmus in BPPV patients. BPPV patients are divided into different subtypes depending on which canal is affected. Our study shows that these subtypes correspond with different degree of patient reported symptoms. E.g. BPPV patients with horizontal canal affection experience a greater handicap. By rotating the chair with additional speed, energy is being transferred to the treatment. This increased the treatment success rate patients with horizontal canal BPPV. The thesis contributes to better diagnostics with regards to differentiation between normal and pathological findings of positional nystagmus, better treatment in the TRV chair and increased knowledge about clinical subtypes of BPPV.
Består avPaper I: Martens C, Goplen FK, Nordfalk KF, Aasen T, Nordahl SHG. Prevalence and Characteristics of Positional Nystagmus in Normal Subjects Otolaryngol Head Neck Surg. 2016 May;154(5):861-7. The article is not available in BORA due to publisher restrictions. The published version is available at: https://doi.org/10.1177%2F0194599816629640
Paper II: Martens C, Goplen FK, Aasen T, Nordfalk KF, Nordahl SHG. Dizziness handicap and clinical characteristics of posterior and lateral canal BPPV Eur Arch Otorhinolaryngol. 2019 Aug;276(8):2181-2189. The article is not available in BORA due to publisher restrictions. The published version is available at: https://doi.org/10.1007/s00405-019-05459-9
Paper III: Martens C, Goplen FK, Aasen T, Nordfalk KF, Gjestad R, Nordahl SHG. Treatment of horizontal canal BPPV-a randomized sham-controlled trial comparing two therapeutic maneuvers of di_erent speeds Laryngoscope Investig Otolaryngol. 2020 Jun 29;5(4):750-757. The article is available at: https://hdl.handle.net/11250/2737928