Postural stability in patients with different durations of benign paroxysmal positional vertigo

Abstract

Postural stability maintenance was investigated in patients with "idiopathic" benign paroxysmal positional vertigo of the posterior semicircular canal (BPPV-PSC) and compared to healthy subjects. To measure the postural stability during a quiet upright stance, we used static posturography in two conditions: with open and with closed eyes. The effect of the repositioning Epley's maneuver on the recovery of postural stability in patients with different durations of BPPV-PSC less than 60 days after the first attack of positioning vertigo (group I) and more than 60 days (group II) was examined. The investigation was made 1 h after the positive Dix-Hallpike test and 7 days after treatment with the Epley maneuver. "Sway velocity" (SV) and "relative power spectrum" (RPS) of the stabilograms were calculated to evaluate the postural stability for each subject and each experimental condition. We found a pronounced spectral density peak in the frequency range of 1.0-2.0 Hz and smaller spectral density in the range of 0.15-0.5 Hz compared to that in healthy subjects. Our results showed that the postural maintenance in BPPV-PSC patients depended on the disease duration. Patients with a duration of BPPV symptoms less than 60 days after the first attack demonstrated a high dependence on the visual input for postural stability. One week after the Epley maneuver, differences in the recovery of postural control in both groups of patients were also found. We assume that the disturbed otolith function together with the impaired dynamics of the semicircular canal generate a particular pattern of postural maintenance. The different degree of restoration of postural stability 1 week after the EM treatment in BPPV-PSC patients with different durations of the disease gives us reason to believe that after removing the otoconia from the semicircular canal, some stimulation of other sensory subsystems and adaptation mechanisms occur that lead to a new pattern of postural maintenance.