Otolith dysfunction in recurrent benign paroxysmal positional vertigo after mild traumatic brain injury

Abstract

Background: The pathogenesis of recurrence of traumatic benign paroxysmal positional vertigo (BPPV) is poorly understood by far.

Objectives: To evaluate the value of secondary otolith dysfunction using vestibular evoked myogenic potential (VEMP) test in the pathogenesis of recurrence of BPPV after mild traumatic brain injury (mTBI).

Material and methods: We reviewed 42 patients with BPPV after mTBI. According to recurrence, patients were divided into two groups. Both cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests were performed on all of them.

Results: We detected abnormal cVEMP responses in four (26.7%) patients in the recurrent BPPV group after mTBI and five (18.5%) patients in the non-recurrent BPPV group after mTBI, and there was no significant difference between both groups. We detected abnormal oVMEP responses in nine (60.0%) patients in the recurrent BPPV group after mTBI and six (22.2%) patients in the non-recurrent BPPV group after mTBI, and there was a significant difference between both groups.

Conclusions and significance: Our study shows that oVEMP abnormalities in recurrent BPPV group after mTBI are significantly higher than those in non-recurrent BPPV group after mTBI. Therefore, we can conclude that secondary utricular dysfunction may be a potential pathogenesis of recurrence of traumatic BPPV.

Chinese abstract

背景：目前对创伤性良性阵发性位置性眩晕症（BPPV）复发的发病机制知之甚少。

目的：探讨用前庭诱发肌源性电位（VEMP）检测对轻度创伤性脑损伤（mTBI）后BPPV复发机制方面, 继发性耳石功能障碍的价值。

材料与方法：对42例mTBI后BPPV患者进行回顾性分析。根据复发情况, 将患者分为两组。对所有患者均进行了颈VEMP（cVEMP）和眼VEMP（oVEMP）检查。

结果：mTBI术后复发性BPPV组4例（26.7%）和MTBI术后非复发性BPPV组5例（18.5%）出现异常cVEMP反应, 两组间无显著性差异。我们检测了MTBI后复发性BPPV组9例（60.0%）和MTBI后非复发性BPPV组6例（22.2%）患者的oVMEP异常反应, 两组之间有显著差异。

结论与意义：我们的研究表明, MTBI术后复发性BPPV组的oVMP异常明显高于MTBI术后非复发性BPPV组。因此, 我们可以得出结论, 继发性包囊功能障碍可能是创伤性BPPV复发的潜在发病机制。

Keywords:

• Benign paroxysmal positional vertigo
• vestibular evoked myogenic potential
• traumatic brain injury
• recurrence

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.