This week, we are going to take a quick look at some (at least to me) startling and depressing statistics related to Benign Paroxysmal Positional Vertigo. Each will be linked to the abstract if you want further detail. I will be exploring current management of BPPV over the next few weeks.
1. Two recent studies explored the time period from initial presentation of symptoms of BPPV to correct diagnosis. Fife and Fitzgerald report that in the United Kingdom, the mean wait time from initial presentation to correct diagnosis was 92 weeks. A more recent study out of China found the delay to be longer than 70 months.
2. In both studies mentioned above, the subjects were treated with Canalith repositioning (CRP) once the diagnosis of BPPV was made. In the Chinese study over 80% were successfully treated with one CRP, while the Fife and Fitzgerald study reports 85% were successfully treated.[Editors note: I don’t know about you, but this blows my mind. This indicates that the average person with BPPV goes years before they are diagnosed correctly, then over 80% are successfully treated on the day they are diagnosed. We know BPPV is common. It is easy and inexpensive to diagnose and treat, yet the inefficiencies of the health care systems seem determined to ignore this. Is it any better in the United States?]
3. Katsarkis (1994) reported that more than one third of 1194 patients seen for the complaint of “dizziness” were found to have “confirmed or strongly suspected” benign paroxysmal positional vertigo (BPPV)
4. Oghali (2000) reports that 9% of the general geriatric population has BPPV at any given time
5. Despite the high incidence of BPPV, testing for positional vertigo is still rare (<10%) in the primary care setting (Polensek, 2008)[Editors note: All three of these studies are from the United States. We will continue with this stat sheet next week, and explore treatment options]
Sadly, I’m not shocked at all by these stats. However, I will say there seems to be more awareness amongst physicians the past few years.
Inevitably though, we get referrals from the MDs for ALL vertigo patients as “BPPV” or “BPV”. Of course, lots of these are not BPPV…which is fine, at least the MDs are more often referring patients in the right direction to help narrow down the possible diagnosis. Our local ER has finally caught on though and seems to be very competent in this regard, so that is encouraging.
Thank you for bringing attention to the need to improve diagnostics for vestibular disorders in general and BPPV in particular. As you mentioned, the AAO-HNS guidelines provide a model approach for the initial evaluation and management of dizzy patients. Among the many differential diagnoses of vestibular disorders, BPPV is not only the most common but also the most recognizable and treatable condition. Nevertheless, patients with BPPV receive delayed diagnosis, inappropriate testing, and ineffective treatment leading to needlessly prolonged suffering, increased risk of falls, decreased productivity, and higher healthcare costs.
The Vestibular Disorders Association advocates for people with inner ear balance disorders by providing education and support, with a focus on reducing diagnosis times and pre-diagnosis doctor visits for vestibular patients while improving treatment effectiveness. We would love to hear from you and others on ways we can collaborate to improve the quality of life for people suffering from dizziness.
Sad story up there , I suffer from it for long time and only now got diagnosed and next thing I will find someone who can treat me, Mister Desmond, I know the condition is benign and I understand that means “harmless” but does it damage the ear or not? I mean , in case the Epley is working will I have a damage left because of the time I had this going on or should the Epley fix it altogether?