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THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE PowerPoint Presentation
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THE DECREASING EFFECT OF THE TREATMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV) ON THE BLOOD PRESSURE - PowerPoint PPT Presentation


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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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slide1

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

background
BACKGROUND
  • Nystag I 1978 Motorola 6800 CPU
  • 1. EQUILIBRIUM MICRO IN SCANDINAVIA
  • 4 CHANNELS, PATTERN RECOGNITION PRINCIPLE
  • SAMPLING FREQUENCY 200 HZ
  • IN CLICAL USE
background3
BACKGROUND
  • IKARUS PC LINE SINCE 1986
  • VISUAL STIMULATORS LED AND LASER
  • PROGRAMMED ACTIVE POSTUROGRAPHY
  • INFRARED EYE MOVEMENT VIDEO REGISTRATION, 400 FRAMES/SEC
  • ROTATING SURROUNDING
the benign positional vertigo
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
slide5
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
anamnesis
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
tests
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
slide8

THE DISTRIBUTION OF SYMPTOMS IN THE POPULATION

  • ”THE EVENT HORIZON”

CLINICAL VERTIGO

DIZZINESS

N

rahko wrw test
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
rahko test
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.
material and methods
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
material and methods12
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
results
Results
  • The decrease of systolic blood pressure 20 mmHg
  • The decrease of diastolic blood pressure 12 mm Hg
  • See Table below for more information
conclusion
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 ?