Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo
Patients who experience both vertigo and nystagmus in the Dix-Hallpike test (DHT) are diagnosed with objective benign paroxysmal positional vertigo (BPPV). This test provokes only vertigo in between 11% and 48% of patients, who are diagnosed with subjective BPPV. Detection of nystagmus has important...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Spanish |
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Elsevier
2021-10-01
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| Series: | Atención Primaria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0212656721000573 |
| _version_ | 1828924329347252224 |
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| author | José Luis Ballve Moreno Ricard Carrillo Muñoz Yolanda Rando Matos Iván Villar Balboa Oriol Cunillera Puértolas Jesús Almeda Ortega |
| author_facet | José Luis Ballve Moreno Ricard Carrillo Muñoz Yolanda Rando Matos Iván Villar Balboa Oriol Cunillera Puértolas Jesús Almeda Ortega |
| author_sort | José Luis Ballve Moreno |
| collection | DOAJ |
| description | Patients who experience both vertigo and nystagmus in the Dix-Hallpike test (DHT) are diagnosed with objective benign paroxysmal positional vertigo (BPPV). This test provokes only vertigo in between 11% and 48% of patients, who are diagnosed with subjective BPPV. Detection of nystagmus has important diagnostic and prognostic implications. To compare the characteristics of patients diagnosed with objective and subjective BPPV in primary care. Cross-sectional descriptive study. Two urban primary care centers. Adults (≥18 years) diagnosed with objective or subjective BPPV between November 2012 and January 2015. DHT results (vertigo or vertigo plus nystagmus; dependent variable: nistagmus as response to DHT), age, sex, time since onset, previous vertigo episodes, self-reported vertigo severity (Likert scale, 0–10), comorbidities (recent viral infection, traumatic brain injury, headache, anxiety/depression, hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, altered thyroid function, osteoporosis, cervical spondylosis, neck pain). In total, 134 patients (76.1% women) with a mean age of 52 years were included; 59.71% had subjective BPPV. Objective BPPV was significantly associated with hypertension, antihypertensive therapy, and cervical spondylosis in the bivariate analysis and with cervical spondylosis (OR = 3.94, p = 0.021) and antihypertensive therapy (OR 3.02, p = 0.028) in the multivariate analysis. Patients with subjective BPPV were more likely to be taking benzodiazepines [OR 0.24, p = 0.023]. The prevalence of subjective BPPV was higher than expected. Cervical spondylosis and hypertensive therapy were associated with objective BPPV, while benzodiazepines were associated with subjective BPPV. Resumen: A los pacientes que experimentan tanto vértigo como nistagmo en la prueba de Dix-Hallpike (DHT) se les diagnostica vértigo posicional paroxístico benigno objetivo (VPPB). Esta prueba provoca solamente vértigo entre el 11 y el 48% de los pacientes a los que se les diagnostica VPPB subjetivo. La detección de nistagmo tiene importantes implicaciones diagnósticas y pronósticas. Comparar las características de los pacientes diagnosticados de VPPB objetivo y subjetivo en Atención Primaria. Estudio descriptivo transversal. Ubicación: 2 centros urbanos de Atención Primaria. Participantes: adultos (≥18 años) diagnosticados de VPPB objetivo o subjetivo entre noviembre del 2012 y enero del 2015. Resultados de la DHT (vértigo o vértigo más nistagmo; variable dependiente: nistagmo como respuesta a la DHT), edad, sexo, tiempo desde el inicio, episodios de vértigo previos, gravedad del vértigo autoinformada (escala Likert, 0-10), comorbilidades (infección viral reciente, lesión cerebral traumática, dolor de cabeza, ansiedad/depresión, hipertensión, diabetes mellitus, dislipidemia, enfermedad cardiovascular, función tiroidea alterada, osteoporosis, espondilosis cervical, cervicalgia). Se incluyó a 134 pacientes (76,1% mujeres) con una edad media de 52 años. El 59,71% presentaba VPPB subjetivo. El VPPB objetivo se asoció significativamente con hipertensión, tratamiento antihipertensivo y espondilosis cervical en el análisis bivariado y con espondilosis cervical (OR = 3,94, p = 0,021) y tratamiento antihipertensivo (OR = 3,02, p = 0,028) en el análisis multivariado. Los pacientes con VPPB subjetivo tenían más probabilidades de estar tomando benzodiacepinas (OR = 0,24, p = 0,023). La prevalencia de VPPB subjetivo fue superior a la esperada. La espondilosis cervical y la terapia hipertensiva se asociaron con VPPB objetivo, mientras que las benzodiacepinas se asociaron con VPPB subjetivo. |
| first_indexed | 2024-12-13T22:55:26Z |
| format | Article |
| id | doaj.art-1360a2b9673b457a9cec41dde75c6af6 |
| institution | Directory Open Access Journal |
| issn | 0212-6567 |
| language | Spanish |
| last_indexed | 2024-12-13T22:55:26Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Atención Primaria |
| spelling | doaj.art-1360a2b9673b457a9cec41dde75c6af62022-12-21T23:28:31ZspaElsevierAtención Primaria0212-65672021-10-01538102023Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigoJosé Luis Ballve Moreno0Ricard Carrillo Muñoz1Yolanda Rando Matos2Iván Villar Balboa3Oriol Cunillera Puértolas4Jesús Almeda Ortega5Equip d’Atenció Primària Florida Nord, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, Spain; Corresponding author.Equip d’Atenció Primària Florida Sud, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, SpainEquip d’Atenció Primària Florida Nord, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, SpainEquip d’Atenció Primària Florida Sud, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, SpainUnitat de Suport a la Recerca Metropolitana Sud, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), SpainUnitat de Suport a la Recerca Metropolitana Sud, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), SpainPatients who experience both vertigo and nystagmus in the Dix-Hallpike test (DHT) are diagnosed with objective benign paroxysmal positional vertigo (BPPV). This test provokes only vertigo in between 11% and 48% of patients, who are diagnosed with subjective BPPV. Detection of nystagmus has important diagnostic and prognostic implications. To compare the characteristics of patients diagnosed with objective and subjective BPPV in primary care. Cross-sectional descriptive study. Two urban primary care centers. Adults (≥18 years) diagnosed with objective or subjective BPPV between November 2012 and January 2015. DHT results (vertigo or vertigo plus nystagmus; dependent variable: nistagmus as response to DHT), age, sex, time since onset, previous vertigo episodes, self-reported vertigo severity (Likert scale, 0–10), comorbidities (recent viral infection, traumatic brain injury, headache, anxiety/depression, hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, altered thyroid function, osteoporosis, cervical spondylosis, neck pain). In total, 134 patients (76.1% women) with a mean age of 52 years were included; 59.71% had subjective BPPV. Objective BPPV was significantly associated with hypertension, antihypertensive therapy, and cervical spondylosis in the bivariate analysis and with cervical spondylosis (OR = 3.94, p = 0.021) and antihypertensive therapy (OR 3.02, p = 0.028) in the multivariate analysis. Patients with subjective BPPV were more likely to be taking benzodiazepines [OR 0.24, p = 0.023]. The prevalence of subjective BPPV was higher than expected. Cervical spondylosis and hypertensive therapy were associated with objective BPPV, while benzodiazepines were associated with subjective BPPV. Resumen: A los pacientes que experimentan tanto vértigo como nistagmo en la prueba de Dix-Hallpike (DHT) se les diagnostica vértigo posicional paroxístico benigno objetivo (VPPB). Esta prueba provoca solamente vértigo entre el 11 y el 48% de los pacientes a los que se les diagnostica VPPB subjetivo. La detección de nistagmo tiene importantes implicaciones diagnósticas y pronósticas. Comparar las características de los pacientes diagnosticados de VPPB objetivo y subjetivo en Atención Primaria. Estudio descriptivo transversal. Ubicación: 2 centros urbanos de Atención Primaria. Participantes: adultos (≥18 años) diagnosticados de VPPB objetivo o subjetivo entre noviembre del 2012 y enero del 2015. Resultados de la DHT (vértigo o vértigo más nistagmo; variable dependiente: nistagmo como respuesta a la DHT), edad, sexo, tiempo desde el inicio, episodios de vértigo previos, gravedad del vértigo autoinformada (escala Likert, 0-10), comorbilidades (infección viral reciente, lesión cerebral traumática, dolor de cabeza, ansiedad/depresión, hipertensión, diabetes mellitus, dislipidemia, enfermedad cardiovascular, función tiroidea alterada, osteoporosis, espondilosis cervical, cervicalgia). Se incluyó a 134 pacientes (76,1% mujeres) con una edad media de 52 años. El 59,71% presentaba VPPB subjetivo. El VPPB objetivo se asoció significativamente con hipertensión, tratamiento antihipertensivo y espondilosis cervical en el análisis bivariado y con espondilosis cervical (OR = 3,94, p = 0,021) y tratamiento antihipertensivo (OR = 3,02, p = 0,028) en el análisis multivariado. Los pacientes con VPPB subjetivo tenían más probabilidades de estar tomando benzodiacepinas (OR = 0,24, p = 0,023). La prevalencia de VPPB subjetivo fue superior a la esperada. La espondilosis cervical y la terapia hipertensiva se asociaron con VPPB objetivo, mientras que las benzodiacepinas se asociaron con VPPB subjetivo.http://www.sciencedirect.com/science/article/pii/S0212656721000573Vértigo posicional paroxístico benignoAtención PrimariaNistagmo patológico |
| spellingShingle | José Luis Ballve Moreno Ricard Carrillo Muñoz Yolanda Rando Matos Iván Villar Balboa Oriol Cunillera Puértolas Jesús Almeda Ortega Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo Atención Primaria Vértigo posicional paroxístico benigno Atención Primaria Nistagmo patológico |
| title | Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo |
| title_full | Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo |
| title_fullStr | Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo |
| title_full_unstemmed | Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo |
| title_short | Responses to the Dix-Hallpike test in primary care: A comparison between subjective and objective benign paroxysmal positional vertigo |
| title_sort | responses to the dix hallpike test in primary care a comparison between subjective and objective benign paroxysmal positional vertigo |
| topic | Vértigo posicional paroxístico benigno Atención Primaria Nistagmo patológico |
| url | http://www.sciencedirect.com/science/article/pii/S0212656721000573 |
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