Negative impact of vestibular suppressant drugs on provocative positional tests of BPPV: A study from the Western Part of India

Jayanti Gurumukhani, Dhruvkumar Patel, Sudhir Shah, Mukundkumar Patel, Maitri Patel, Anand Patel

    Research output: Contribution to journalArticlepeer-review

    2 Scopus citations

    Abstract

    Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30-4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2-197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients. Study Design: Prospective case-control observational study.

    Original languageEnglish (US)
    Pages (from-to)367-371
    Number of pages5
    JournalAnnals of Indian Academy of Neurology
    Volume24
    Issue number3
    DOIs
    StatePublished - May 1 2021

    Keywords

    • Dix-Hallpike test
    • objective BPPV
    • provocative position test
    • subjective BPPV
    • supine roll test
    • vestibular suppressant drugs

    ASJC Scopus subject areas

    • Clinical Neurology

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