후반고리관 양성돌발두위현훈의 치료에서 재평가 시기에 대한 피로 현상의 영향open accessInfluence of Fatigability on the Timing of Reassessment in the Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo
- Other Titles
- Influence of Fatigability on the Timing of Reassessment in the Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo
- Authors
- 김창희; 신정은; 신용국; 송미현; 심대보
- Issue Date
- Dec-2018
- Publisher
- 대한이비인후과학회
- Keywords
- Benign paroxysmal positional vertigo; Fatigue; Reassessment
- Citation
- 대한이비인후과학회지 두경부외과학, v.61, no.12, pp.658 - 662
- Indexed
- KCI
- Journal Title
- 대한이비인후과학회지 두경부외과학
- Volume
- 61
- Number
- 12
- Start Page
- 658
- End Page
- 662
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/148741
- DOI
- 10.3342/kjorl-hns.2018.00353
- Abstract
- Background and Objectives The early assessment of treatment is not done for benign paroxysmalpositional vertigo (BPPV) since the well-known phenomenon of fatigability after arepeated positional test can mimic successful treatment. The aim of this study is to evaluate theclinical implication of ‘fatigability’ after Epley maneuver and to identify the therapeutic efficacyof Epley maneuver in posterior canal BPPV (PC-BPPV).
Subjects and Method This study was prospectively conducted by two dizziness clinics on51 consecutive patients diagnosed with PC-BPPV. All patients included in the study receivedEpley maneuver treatment. The therapeutic results were reassessed immediately after a singletrial of Epley maneuver. After 30 minutes, results were reassessed repeatedly to confirm thefatigability of diagnostic procedure immediately after treatment. If the treatment was not successfulafter 30 minutes, Epley maneuver was repeatedly performed until complete resolution.
Results Immediately after the first maneuver, 45 of 51 (88.2%) patients had neither vertigonor nystagmus during the positional test. All patients demonstrated complete resolution afterreceiving one to three Epley maneuvers on the day of diagnosis. ‘Fatigability (false negativeresult)’ was confirmed for only one case (1 of 6 patients, 16.7%), in which nystagmus was observedafter 30 minutes but not identified immediately after the first Epley maneuver.
Conclusion The therapeutic efficacy of Epley maneuver is very high in PC-BPPV. Consideringthe possibility of fatigability when reassessment is performed immediately after therapeuticmaneuver, clinicians should avoid assessing the outcome immediately after treatment in patientswith PC-BPPV.
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