외상성 양성 돌발성 체위성 현훈과 특발성 양성 돌발성 체위성 현훈의 임상적 특징의 비교

Abstract

Background and Objectives Benign paroxysmal positional vertigo (BPPV) is one of the most common diseases in patients with dizziness after head trauma. The aim of the study was to investigate the clinical characteristics of the traumatic BPPV (tBPPV) compared with idiopathic BPPV (iBPPV).

Subjects and Method From January 2008 to June 2015, a retrospective review was performed on 572 patients diagnosed with BPPV and treated with appropriate canalith reposition maneuver. Clinical characteristics of patients, such as age, sex, affected semicircular canal, and number of reposition maneuver were evaluated and compared between iBPPV and tBPPV. Canal change and recurrence rate were also assessed.

Results Among 572 BPPV patients, 509 were iBPPV and 63 were tBPPV. The male to female ratio was higher in tBPPV (26/37) than in iBPPV (142/367) (p=0.028). Posterior semicircular canal (PSCC) was more commonly affected than lateral semicircular canal in the tBPPV group compared with the iBPPV group (38/18 vs. 244/257). Also multiple canal was more commonly affected in the tBPPV group than in the iBPPV group (11.11/3.54%) (p=0.001). The tBPPV group needed fewer number of canalith reposition maneuver for symptom relief than the iBPPV group did (1.35 vs. 1.53, p=0.048). The side of affected canal was more frequently changed in tBPPV than in iBPPV (22.22% vs. 11.98%, p=0.023). There was no significant difference in recurrence rate between tBPPV and iBPPV (18.87% vs. 19.25%, p=0.518). However, the tBPPV group had a tendency of earlier recurrence than the iBPPV patients (1.33 month vs. 2.86 month, p=0.050).

Conclusion tBPPV was more common in male and PSCC was usually affected. The tBPPV patients had a tendency of frequently changing the canal type and an earlier recurrence than the iBPPV patients. These distinguished clinical features would be useful in diagnosing and managing tBPPV patients.