Do equilíbrio em pacientes com vertigem posicional paroxística benigna

Abstract

Introduction: The dizziness is observed among 5 and 10% of the world population, affecting both genders. It can be of two sorts: rotatory (vertigo) or non-rotatory. The dizziness crises may injure the patients life, leading to the reduction of social coexistence and difficult the daily activities. The most common rotatory dizziness is the Benign Positional Paroxysmal Vertigo. The episodes are generally quick and triggered by the head movement, Furthermore, it may be accompanied by nausea, vomiting and fall. The diagnosis of Benign Positional Paroxysmal Vertigo is achieved through the Dix-Halpike maneuver, which shall verify the presence of nystagmus and/or giddiness. There are no reports of variation in conventional tests of patients with complaint of Benign Positional Paroxysmal Vertigo. It is observed only in vectonystagmography. The treatment of this type of dizziness is performed by canalith repositioning maneuvers. Objective: To verify the results found in the evaluations carried out by patients with Benign Positional Paroxysmal Vertigo, with emphasis on the results found in vectonystagmography and its relationship with affected semicircular canal. Material and Method: The study was performed in otology ambulatory of University Hospital of Santa Maria. The sample was composed of all patients who attended the ambulatory with complaints of. The patients have performed anamnesis, Dix-Halpike maneuver, vectonystagmography and Epley maneuver. They were divided in two groups: the control group, composed by patients with negative result in Dix-Halpike maneuver, and the study group, composed by patients with positive result in this maneuver. Results: There was prevalence of females among the patients and the average age was 57 years. The semicircular canal most affected was the anterior and the theory that prevailed was the ductolitiase. The average number of maneuvers necessaries to abolish the positioning nystagmus is 1.58 and there were 4 (6.9%) cases of recurrence. When analyzed the evidence of vectonystagmography, it was observed the presence of spontaneous nystagmus and a change in rotator testing. However, these variations are not related to the affected semicircular canal. It has occurred a predominance of normorreflexia in the caloric testing. Conclusion: The Epley maneuver is effective for patients with Benign Positional Paroxysmal Vertigo, even in cases in which they occur relapses. The variations found in vectonystagmography are not related to the affected semicircular canal. In fact, these variations are arising from the spontaneous and latent nystagmus presence. Consequently, it was not possible to verify other methods for the diagnosis of Benign Positional Paroxysmal Vertigo.