Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans Background The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV ... Clinical Focus
Clinical Focus  |   December 12, 2017
Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans
 
Author Affiliations & Notes
  • Faith W. Akin
    Vestibular Balance Laboratory and Auditory Vestibular Research Enhancement Award Program, James H. Quillen VA Veterans Affairs Medical Center, Mountain Home, TN
    Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City
  • Kristal M. Riska
    Vestibular Balance Laboratory and Auditory Vestibular Research Enhancement Award Program, James H. Quillen VA Veterans Affairs Medical Center, Mountain Home, TN
    Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City
  • Laura Williams
    Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City
    Audiology and Speech Pathology Service, San Diego VA Medical Center, La Jolla, CA
  • Stephanie B. Rouse
    Vestibular Balance Laboratory and Auditory Vestibular Research Enhancement Award Program, James H. Quillen VA Veterans Affairs Medical Center, Mountain Home, TN
  • Owen D. Murnane
    Vestibular Balance Laboratory and Auditory Vestibular Research Enhancement Award Program, James H. Quillen VA Veterans Affairs Medical Center, Mountain Home, TN
    Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Faith Akin: Faith.akin@va.gov
  • Kristal M. Riska is now at Duke University Medical Center, Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Durham, NC.
    Kristal M. Riska is now at Duke University Medical Center, Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Durham, NC.×
  • Editor: Sumitrajit Dhar
    Editor: Sumitrajit Dhar×
  • Associate Editor: Ann Eddins
    Associate Editor: Ann Eddins×
Article Information
Balance & Balance Disorders / Clinical Focus
Clinical Focus   |   December 12, 2017
Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans
American Journal of Audiology, December 2017, Vol. 26, 473-480. doi:10.1044/2017_AJA-16-0118
History: Received December 8, 2016 , Revised March 30, 2017 , Accepted April 24, 2017
 
American Journal of Audiology, December 2017, Vol. 26, 473-480. doi:10.1044/2017_AJA-16-0118
History: Received December 8, 2016; Revised March 30, 2017; Accepted April 24, 2017

Background The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV and treatment efficacy have not been reported in a cohort of veterans with BPPV.

Purpose To determine the prevalence and characteristics of veterans diagnosed with BPPV in a Veterans Affairs Medical Center Audiology Clinic and to examine treatment outcomes.

Research Design Retrospective chart review.

Study Sample A total of 102 veterans who tested positive for BPPV in the Vestibular Clinic at the Mountain Home VA Medical Center from March 2010 to August 2011.

Results In 102 veterans who were diagnosed with BPPV, the posterior semicircular canal was most often involved (75%), motion-provoked vertigo was the most common symptom (84%), and the majority (43%) were diagnosed with BPPV in their sixth decade. The prevalence of BPPV in the Audiology Vestibular Clinic was 15.6%. Forty-one percent of veterans reported a symptom onset within 12 months of treatment for BPPV; however, 36% reported their symptoms began > 36 months prior to treatment. CRT was effective (negative Dix–Hallpike/roll test) in most veterans (86%) following 1 treatment appointment (M = 1.6), but more than half reported incomplete symptom resolution (residual dizziness) at the follow-up appointment. Eighteen percent of veterans experienced a recurrence (M = 1.8 years; SD = 1.7 years).

Conclusions The characteristics and treatment outcomes of BPPV in our veteran cohort was similar to what has been reported in the general population. Future work should focus on improving the timeliness of evaluation and treatment of BPPV and examining the time course and management of residual dizziness.

Acknowledgments
This work was presented at the Joint Defense Veterans Audiology Conference, Nashville, Tennessee, in February 2013 and at the American Balance Society Annual Meeting in Scottsdale, Arizona, in March 2012. Support for this study was provided by the Auditory Vestibular Research Enhancement Award Program sponsored by the Rehabilitation Research and Development Service, Department of Veterans Affairs, Washington, D.C. (awarded to Faith W. Akin and Owen D. Murnane). The authors would like to acknowledge Ginny Alexander and Dr. Courtney Hall for their help with the database and research design, respectively.
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