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J Am Acad Audiol
DOI: 10.1055/s-0044-1790261
Research Article

Relationship between Location of Focal Traumatic Brain Injury and Canal Involved in Benign Paroxysmal Positional Vertigo

Regan G. Harrell 
1   Department of Physical Therapy, University of Pittsburgh, School of Rehabilitation Sciences, Pittsburgh, Pennsylvania
,
Chelsea J. Manetta
1   Department of Physical Therapy, University of Pittsburgh, School of Rehabilitation Sciences, Pittsburgh, Pennsylvania
2   Center for Rehabilitation Services, UPMC, Pittsburgh, Pennsylvania
,
Susan L. Whitney
1   Department of Physical Therapy, University of Pittsburgh, School of Rehabilitation Sciences, Pittsburgh, Pennsylvania
3   Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Abstract

Introduction Benign paroxysmal positional vertigo (BPPV) has a prevalence of 58% in a traumatic brain injury (TBI) population. Research on idiopathic BPPV has demonstrated a higher prevalence of right-sided canal involvement. While many studies have investigated the epidemiology of canal involvement in BPPV in both idiopathic and traumatic BPPV (BPPV associated with a fall), there has been no assessment of trauma location as a predictor of the location of BPPV.

Objectives The aim of this study was to assess the relationship between the location of a focal TBI and canal involvement in BPPV.

Methods Patients who were admitted to an inpatient rehabilitation unit with a diagnosis of TBI were screened for BPPV. The primary outcome of this study was the side of the TBI, the BPPV type (posterior, horizontal, or anterior canal), and the side of the BPPV (right, left, or bilateral).

Results There were 42 people who had BPPV. Twenty-one had right-sided canal involvement, 14 had left-sided involvement, and 7 had bilateral involvement. Sixteen had right-side tissue involvement, 13 had left-side involvement, and 13 had bilateral involvement. There was no significant correlation between variables (χ2 = 1.70, p = 0.80).

Conclusion All patients with a TBI should have all canals assessed for BPPV as there is no relationship between the side of focal damage and canal involvement.

Keywords

benign paroxysmal positional vertigo - traumatic brain injury - positional - testing


Publication History

Received: 20 December 2022

Accepted: 21 April 2023

Article published online:
04 October 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Dewan MC, Rattani A, Gupta S. et al. Estimating the global incidence of traumatic brain injury. J Neurosurg 2018; 130 (04) 1080-1097
    CrossrefPubMedGoogle Scholar
  • 2 Iaccarino C, Carretta A, Nicolosi F, Morselli C. Epidemiology of severe traumatic brain injury. J Neurosurg Sci 2018; 62 (05) 535-541
    CrossrefPubMedGoogle Scholar
  • 3 Capizzi A, Woo J, Verduzco-Gutierrez M. Traumatic brain injury: an overview of epidemiology, pathophysiology, and medical management. Med Clin North Am 2020; 104 (02) 213-238
    CrossrefPubMedGoogle Scholar
  • 4 Dever A, Powell D, Graham L. et al. Gait impairment in traumatic brain injury: a systematic review. Sensors (Basel) 2022; 22 (04) 1480
    CrossrefPubMedGoogle Scholar
  • 5 Barman A, Chatterjee A, Bhide R. Cognitive impairment and rehabilitation strategies after traumatic brain injury. Indian J Psychol Med 2016; 38 (03) 172-181
    CrossrefPubMedGoogle Scholar
  • 6 Andriessen TM, Jacobs B, Vos PE. Clinical characteristics and pathophysiological mechanisms of focal and diffuse traumatic brain injury. J Cell Mol Med 2010; 14 (10) 2381-2392
    CrossrefPubMedGoogle Scholar
  • 7 Jones RM, Rothman MI, Gray WC, Zoarski GH, Mattox DE. Temporal lobe injury in temporal bone fractures. Arch Otolaryngol Head Neck Surg 2000; 126 (02) 131-135
    CrossrefPubMedGoogle Scholar
  • 8 Khan S, Chang R. Anatomy of the vestibular system: a review. NeuroRehabilitation 2013; 32 (03) 437-443
    CrossrefPubMedGoogle Scholar
  • 9 Harrell R, Manetta C, Guthrie M, Enam N. The prevalence of symptom reporting for benign paroxysmal positional vertigo in a traumatic brain injury population. Otol Neurotol 2023; 44 (02) 172-176
    CrossrefPubMedGoogle Scholar
  • 10 Alashram AR, Annino G, Raju M, Padua E. Effects of physical therapy interventions on balance ability in people with traumatic brain injury: a systematic review. NeuroRehabilitation 2020; 46 (04) 455-466
    CrossrefPubMedGoogle Scholar
  • 11 Bhattacharyya N, Gubbels SP, Schwartz SR. et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 2017; 156 (3_suppl, suppl): S1-S47
    CrossrefPubMedGoogle Scholar
  • 12 Mallinson A, Maire R, Beyaert C. et al. Understanding and managing trauma-induced vestibular deficits. J Int Adv Otol 2021; 17 (06) 559-565
    CrossrefPubMedGoogle Scholar
  • 13 Haripriya GR, Mary P, Dominic M, Goyal R, Sahadevan A. Incidence and treatment outcomes of post traumatic BPPV in traumatic brain injury patients. Indian J Otolaryngol Head Neck Surg 2018; 70 (03) 337-341
    CrossrefPubMedGoogle Scholar
  • 14 Motin M, Keren O, Groswasser Z, Gordon CR. Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment. Brain Inj 2005; 19 (09) 693-697
    CrossrefPubMedGoogle Scholar
  • 15 Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med 1952; 45 (06) 341-354
    PubMedGoogle Scholar
  • 16 Lempert T, Tiel-Wilck K. A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope 1996; 106 (04) 476-478
    CrossrefPubMedGoogle Scholar
  • 17 Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39 (02) 175-191
    CrossrefPubMedGoogle Scholar
  • 18 Ferguson CJ. An Effect Size Primer: A Guide for Clinicians and Researchers. Washington, DC: American Psychological Association; 2016: 301-310
    Google Scholar
  • 19 von Brevern M, Seelig T, Neuhauser H, Lempert T. Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry 2004; 75 (10) 1487-1488
    CrossrefPubMedGoogle Scholar
  • 20 Katsarkas A. Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic. Acta Otolaryngol 1999; 119 (07) 745-749
    CrossrefPubMedGoogle Scholar
  • 21 Lopez-Escámez JA, Gámiz MJ, Fiñana MG, Perez AF, Canet IS. Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol 2002; 23 (05) 263-266
    CrossrefPubMedGoogle Scholar
  • 22 Gyo K. Benign paroxysmal positional vertigo as a complication of postoperative bedrest. Laryngoscope 1988; 98 (03) 332-333
    CrossrefPubMedGoogle Scholar
  • 23 Christie RJ. Therapeutic positioning of the multiply-injured trauma patient in ICU. Br J Nurs 2008; 17 (10) 638-642
    CrossrefPubMedGoogle Scholar
  • 24 Thomas PJ, Paratz JD, Stanton WR, Deans R, Lipman J. Positioning practices for ventilated intensive care patients: current practice, indications and contraindications. Aust Crit Care 2006; 19 (04) 122-126 , 128, 130–132
    CrossrefPubMedGoogle Scholar
  • 25 Olkowski BF, Shah SO. Early mobilization in the neuro-ICU: how far can we go?. Neurocrit Care 2017; 27 (01) 141-150
    CrossrefPubMedGoogle Scholar
  • 26 Imai T, Takeda N, Ikezono T. et al; Committee for Standards in Diagnosis of Japan Society for Equilibrium Research. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx 2017; 44 (01) 1-6
    CrossrefPubMedGoogle Scholar
  • 27 Oghalai JS, Manolidis S, Barth JL, Stewart MG, Jenkins HA. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000; 122 (05) 630-634
    CrossrefPubMedGoogle Scholar