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THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE

THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE. TAPANI RAHKO 1 AND JORMA LAHTELA 2 THE CLINICS OF OTOLARYNGOLOGY 1 AND MEDICINE 2 ,TAMPERE UNIVERSITY

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THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE

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  1. THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE TAPANI RAHKO 1 AND JORMA LAHTELA 2 THE CLINICS OF OTOLARYNGOLOGY 1 AND MEDICINE 2 ,TAMPERE UNIVERSITY PRESENTED 25.04.2003 IN FINNISH HYPERTENSION SOCIETY MEETING : HYPERTENSION; GENES AND ENVIRONMENT FINLANDIA HOUSE,HELSINKI,FINLAND

  2. BACKGROUND • Nystag I 1978 Motorola 6800 CPU • 1. EQUILIBRIUM MICRO IN SCANDINAVIA • 4 CHANNELS, PATTERN RECOGNITION PRINCIPLE • SAMPLING FREQUENCY 200 HZ • IN CLICAL USE

  3. BACKGROUND • IKARUS PC LINE SINCE 1986 • VISUAL STIMULATORS LED AND LASER • PROGRAMMED ACTIVE POSTUROGRAPHY • INFRARED EYE MOVEMENT VIDEO REGISTRATION, 400 FRAMES/SEC • ROTATING SURROUNDING

  4. THE BENIGN POSITIONAL VERTIGO • THE INERTIAMASS OF CALSIUN CARBONATE GRAINS OF UTRICLE FOR LINEAR ACCELERATION INPUT MOVE TO SEMICIRCULAR CANALS; POSTERIOR, HORIZONTAL AND SUPERIOR AND PRODUCE AN UNPREDICTABLE DISTURBANCE OF ROTATION INPUT:VERTIGO

  5. BPPV • PRESENT IN >80 % OF ALL VERTIGO • BPPV IS AS A MAIN COMPONENT IN THE BACKGROUND OF DIZZINESS • STACK PRINCIPLE: SEVERAL FACTORS NEEDED SIMULTANEOUSLY TO CREATE VERTIGO

  6. ANAMNESIS • AGAROPHOBIA, AGORAPHOBIA, CLAUSTROFOBIA FEAR OF FLYING • COORDINATION PROBLEMS • DYSLEXIA LEARNING PROBLEMS • MOTION SICKNESS DIFFICULT TO READ IN CAR • LEFT RIGHT DISCRIMINATION DIFFICULT • CAROUSEL PROBLEMS • ANYONE OF THESE IS INDICATIVE OF OCI

  7. TESTS • POSTERIOR CANAL: HALLPIKE 1952 • HORIZONTAL:RAHKO WRW 1998,2001 • SUPERIOR: RAHKO 1999,2002 • NOW POSSIBLE TO FIND MILDER FORMS TO VERY MILD ; DIZZINESS; OLD PEOPLE COORDINATION,SIGHT ETC PROBLEMS

  8. THE DISTRIBUTION OF SYMPTOMS IN THE POPULATION • ”THE EVENT HORIZON” CLINICAL VERTIGO DIZZINESS N

  9. Rahko WRW test • The patient with closed eyes walks forward , turns around on the left foot to the left and returns • the same to the right • if inconsistencies in some direction the finding positive in regard to the horizontal vestibular canal of the side

  10. Rahko test • Bow forwards with closed eyes 30 degrees • Straighten and keep position 30 sec • Repeat 4-5 times • Slow sideways movement +, not fast correction • Nearly allways the same side as horizontal + • Treat allways Lempert, Rahko and Semont positional treatments of the same side • Sometimes +on both sides.

  11. MATERIAL AND METHODS • 34 PATIENTS WITH TYPICAL ANAMNESIS AND ELEVATED BLOOD PRESSURE FROM THE ROUTINE OUTPATIENTS • 1-3 MEDICINES, BETA BLOCKERS, ACE , DIURETICS • MEASUREMENT BEFORE AND AFTER THE TREATMENT IDENTICALLY

  12. MATERIAL AND METHODS • MEANS OF THE BLOOD PRESSURE. • SEVERAL YEARS OF MEDICATION • THE PATIENTS WERE NOT TOLD IN EVERY CASE WHAT THE EFFECT MIGHT BE TO BLOOD PRESSURE • HALF OF THE PATIENTS DID NOT HAVE A CLINICAL VERTIGO

  13. Results • The decrease of systolic blood pressure 20 mmHg • The decrease of diastolic blood pressure 12 mm Hg • See Table below for more information

  14. Conclusion • When the muscle tension to compensate BPPV to maintain balance gets unnecessary, vasodilatation occurs in relaxed muscle system. • The elevated blood pressure decreases. • Essential hypertension: This phenomenon is probably one background • Hypertension treatment: Additional factor ?

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