caa a22 4500 606187316 CHVBK 20210128100840.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00405-014-3399-2 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3399-2 First-referral presentations of patients with benign paroxysmal positional vertigo who were negative on positional testing and who lacked nystagmus [Elektronische Daten] [Jun Tan, Dongzhen Yu, Yanmei Feng, Qiang Song, Jin You, Haibo Shi, Shankai Yin] The aim of the present study was to explore the demographic, clinical, and pathogenetic features; and treatment outcomes of patients with benign paroxysmal positional vertigo (BPPV) who were negative upon positional testing at their first referral. A total of 133 patients presented with histories of BPPV but were negative, in our hands, upon positional testing. Patients were told to cease taking vestibular suppressant medication (if any) and were to return for re-examination when positional vertigo symptoms recurred. If BPPV was diagnosed, the appropriate repositioning maneuver was applied and patients were re-examined weekly until the characteristic nystagmus and vertigo disappeared. Follow-up was performed 1week, 4weeks, 3months, 6months, and 1year after diagnosis. The 133 patients were compared with a group of 250 patients with typical BPPV. Sixty-five of the 133 patients (termed the n-BPPV group) were subsequently identified with typical BPPV. Such diagnoses were made within 10days of the first referral in 37 (56.9%) cases. Patients of the n-BPPV group had a longer duration of the last episode of vertigo than did others (39.7±38.4 vs. 26.1±36.7days, p<0.001), and a higher proportion used vestibular suppressant medication prior to first referral (75.4 vs. 54.8%, p=0.003). The n-BPPV and typical BPPV patients responded similarly to treatment and exhibited similar recurrence rates. BPPV patients who were negative upon positional testing at first referral were quite common, accounting for 26% of all typical BPPV patients. No significant difference in either treatment outcome or recurrence rate was evident between n-BPPV and typical BPPV positions. Positional vertigo and nystagmus are not always present as BPPV progresses. Springer-Verlag Berlin Heidelberg, 2014 Benign paroxysmal positional vertigo nationallicence Positional testing nationallicence Nystagmus nationallicence Treatment nationallicence Recurrence nationallicence Tan Jun Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut Yu Dongzhen Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut Feng Yanmei Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut Song Qiang Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut You Jin Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut Shi Haibo Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut Yin Shankai Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3247-3251 0937-4477 272:11<3247 2015 272 405 https://doi.org/10.1007/s00405-014-3399-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3399-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tan Jun Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- Yu Dongzhen Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- Feng Yanmei Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- Song Qiang Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- You Jin Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- Shi Haibo Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 700 1- Yin Shankai Department of Otolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, China aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/11(2015-11-01), 3247-3251 0937-4477 272:11<3247 2015 272 405