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...

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Autores: Ballvé Moreno, José Luis, Carrillo Muñoz, Ricard, Rando-Matos, Yolanda, Villar Balboa, Iván, Cunillera, Oriol
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/180539
Acesso em linha:https://hdl.handle.net/2445/180539
Access Level:acceso abierto
Palavra-chave:Vertigen
Atenció primària
Nistagme
Vertigo
Primary care
Nystagmus
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spelling Responses to the Dix-Hallpike test in primary care: a comparison between subjective and objective benign paroxysmal positional vertigoDetección de nistagmo en respuesta a la prueba de Dix-Hallpike en atención primaria: una comparación entre vértigo posicional paroxístico benigno subjetivo y objetivoBallvé Moreno, José LuisCarrillo Muñoz, RicardRando-Matos, YolandaVillar Balboa, IvánCunillera, OriolVertigenAtenció primàriaNistagmeVertigoPrimary careNystagmusPatients 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.Elsevier España2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/180539Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.aprim.2021.102023Atención Primaria, 2021, vol. 53, num. 8, p. 102023https://doi.org/10.1016/j.aprim.2021.102023cc-by-nc-nd (c) Ballvé Moreno, José Luis et al., 2021https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1805392026-05-27T06:46:51Z
dc.title.none.fl_str_mv Responses to the Dix-Hallpike test in primary care: a comparison between subjective and objective benign paroxysmal positional vertigo
Detección de nistagmo en respuesta a la prueba de Dix-Hallpike en atención primaria: una comparación entre vértigo posicional paroxístico benigno subjetivo y objetivo
title Responses to the Dix-Hallpike test in primary care: a comparison between subjective and objective benign paroxysmal positional vertigo
spellingShingle Responses to the Dix-Hallpike test in primary care: a comparison between subjective and objective benign paroxysmal positional vertigo
Ballvé Moreno, José Luis
Vertigen
Atenció primària
Nistagme
Vertigo
Primary care
Nystagmus
title_short 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_sort Responses to the Dix-Hallpike test in primary care: a comparison between subjective and objective benign paroxysmal positional vertigo
dc.creator.none.fl_str_mv Ballvé Moreno, José Luis
Carrillo Muñoz, Ricard
Rando-Matos, Yolanda
Villar Balboa, Iván
Cunillera, Oriol
author Ballvé Moreno, José Luis
author_facet Ballvé Moreno, José Luis
Carrillo Muñoz, Ricard
Rando-Matos, Yolanda
Villar Balboa, Iván
Cunillera, Oriol
author_role author
author2 Carrillo Muñoz, Ricard
Rando-Matos, Yolanda
Villar Balboa, Iván
Cunillera, Oriol
author2_role author
author
author
author
dc.subject.none.fl_str_mv Vertigen
Atenció primària
Nistagme
Vertigo
Primary care
Nystagmus
topic Vertigen
Atenció primària
Nistagme
Vertigo
Primary care
Nystagmus
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.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/180539
url https://hdl.handle.net/2445/180539
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.aprim.2021.102023
Atención Primaria, 2021, vol. 53, num. 8, p. 102023
https://doi.org/10.1016/j.aprim.2021.102023
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Ballvé Moreno, José Luis et al., 2021
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Ballvé Moreno, José Luis et al., 2021
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier España
publisher.none.fl_str_mv Elsevier España
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300724

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