Posttraumatic Vertigo Follow-up

Updated: Jul 11, 2018
  • Author: Brian E Benson, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Follow-up

Further Outpatient Care

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  • Close follow-up is essential for treatment of patients with posttraumatic vertigo.

  • Vestibular rehabilitation can help patients to cope with vertigo.

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Complications

Treatment failures are most likely secondary to misdiagnosis. Posttraumatic vertigo can be treated successfully once the underlying cause is identified. The causes can be identified in most cases using the appropriate history, physical examination, and neurotological tests.

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Prognosis

The prognosis depends on the diagnosis and the response to conservative therapy. A literature review by Aron et al suggested that symptom resolution rates in posttraumatic BPPV are comparable to those in nontraumatic BPPV. The investigators added, however, that multicanal involvement may be more prevalent in posttraumatic BPPV, leading to the need for more repositioning maneuvers in these patients than in those with the nontraumatic variety. They also stated that more studies are needed to prove their assertions, owing to a current lack of well-designed studies with adequate cohorts. [14]

A study by Prokopakis et al suggested that canalith repositioning procedures have less long-term efficacy in patients with BPPV who have suffered head trauma than in other patients with the condition. The study involved 965 patients, who were followed up at 48 hours and 7 days following their initial treatment and then every 6 months, for a mean total of 74 months. They were treated with variants of either the Epley maneuver or the barbecue roll maneuver, depending on whether they had posterior and anterior canal involvement or horizontal canal involvement, respectively. The investigators found that symptoms of benign paroxysmal positional vertigo recurred in 139 patients, with the recurrence rate being significantly greater in patients with head trauma, as well as in elderly patients and in those with a history of vestibular neuropathy. [15]

On the other hand, a retrospective study by Luryi et al did not find a traumatic etiology for BPPV to be linked to a greater risk for the condition’s recurrence. [16]

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