Combination of head-up sleep and vertical recognition training may cure intractable motion-evoked dizziness with unknown origin. (2nd June 2020)

• Record Type: Journal Article
• Authors: Kitahara, Tadashi; Horinaka, Akira; Shiozaki, Tomoyuki; Ito, Taeko; Wada, Yoshiro; Yamanaka, Toshiaki; Nario, Kazuhiko
• Is Part Of: Acta oto-laryngologica. Volume 140:Number 6(2020)
• Page Start: 467
• Page End: 472
• Publication Date: 2020-06-02
• Subjects: Unknown origin -- undiagnosed -- possible BPPV -- no obvious nystagmus -- subjective visual vertical -- head-up sleep -- vertical recognition training; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2020.1727566
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: It has been reported that head-up sleep (HUS) prevents free-floating otoliths from entering canals and that vertical recognition training (VRT) promotes vestibular compensation. Aims/objectives: We would like to assess HUS and VRT for intractable motion-evoked dizziness, including possible benign paroxysmal positional vertigo (BPPV). Materials and methods: 162 patients diagnosed with intractable motion-evoked dizziness of unknown origin were enrolled and randomly divided into the following four groups: HUS−/VRT−, HUS+/VRT−, HUS−/VRT+, and HUS+/VRT+. The at-home interventions comprised HUS with an upper head position of 45° when lying down and VRT with a right down-left down 30° head inclination while watching the vertical index. Results: At the post-treatment 6th month, visual analogue scale (VAS) scores for vertiginous sensation were significantly lower in the HUS+/VRT + group than in the HUS+/VRT − and HUS−/VRT + groups, which were in turn significantly lower than those in the HUS−/VRT − group. VAS scores in the HUS−/VRT + group of patients with abnormal subjective visual vertical (SVV) were significantly lower than those in the HUS+/VRT − group, while those in the HUS+/VRT − group of patients with normal SVV were significantly lower than those in the HUS−/VRT + group. Conclusions: HUS and/or VRT is a good initial treatment for patients with intractable undiagnosed motion-evoked dizziness, including possible BPPV.