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Registration of ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs) reflects the function of otolith receptors: sacculus and utriculus. Benign paroxysmal positional vertigo (BPPV) is a disease of the inner ear as a result of the utriculus disfunction and migration of otoliths into semicircular channels., Objective: To study the function of otolith receptors (sacculus and utriculus) with using VEMPs registration in patients with first-time and recurrent posterior semicircular canal BPPV before and after repositional maneuvers., Material and Methods: Registration and comparison of the results of oVEMPs and cVEMPs were performed in 50 patients with first-time posterior semicircular canal idiopathic BPPV and 26 patients with recurrent posterior semicircular canal BPPV before and after repositional treatment., Results and Discussion: Clinically significant asymmetry of the amplitude of oVEMPs before treatment was recorded in 14 (38%) of patients with first-time BPPV and in 15 (57.7%) of patients with recurrent BPPV; cVEMPs - in 6 (12%) of patients with first-time BPPV and in 6 (23.1%) of patients with recurrent BPPV. Successful repositional treatment did not affect the amplitude of cVEMPs in any of the groups of patients, but led to a significant increase in the amplitude of oVEMPs on the affected side in patients with first-time BPPV. In patients with recurrent BPPV, despite the absence of symptoms of otolithiasis, the asymmetry of the amplitude of oVEMPs persisted during remission ( p <0.05), which can be considered as a prognostically unfavorable factor of disease recurrence.

The objective of the present study was to evaluate the otolith function in the patients presenting with idiopathic benign paroxysmal positional vertigo (pBPPV) attributable to the occlusion of the posterior semicircular canal (PSCC) of the inner ear with the use of vestibular evoked myogenic potentials (VEMP). Cervical (cVEMP) and ocular VEMP (oVEMP) were measured in 34 patients with idiopathic pBPPV before and 7 days after the treatment by means of reposition maneuvers. The results of the repeated Dix-Hallpike test performed 7 days after the repositioning maneuver were negative in 27 patients and positive in 7 patients. There was no statistically significant difference in the amplitude of cervical VEMP between the healthy and affected ears either before or after the repositioning treatment. The measurement of oVEMP revealed a reduction of the response amplitude on the affected side. The average values of the plnl on the healthy side were 12.84±1.09 and those on the affected side 4.62±0.69 (p<0,05). The successful repositioning treatment resulted in a significant increase of the oVEMP amplitude on the affected side (p<0,05). In the patients presenting with the persistent symptoms of pBPPV, the repositioning maneuvers did not cause an appreciable increase in the amplitude of oVEMP on the affected side (p<0.05). The results of the present study give evidence that pBPPV of the posterior semicircular canal is associated with the impairment of the function of the receptor structures of the utriculus and the preserved function of the succulus as suggested by the reduction of the oVEMP amplitude and clinically significant asymmetry of ocular VEMP on the affected side with intact cervical VEMP on both sides. The successful treatment of pBPPV of PSCC with the use of the liberatory maneuver results in the increase of the oVEMP amplitude on the affected side increases while the response asymmetry between both sides significantly decreases which indicates the repair of the utriculus otolith function.

The objective of the present study was to elucidate the prevalence of various forms of benign paroxysmal positional vertigo (BPPV) among the patients with the complaints of dizziness who had applied for the medical aid. The secondary objective was to evaluate the effectiveness of the newly developed algorithm for the diagnostics and treatment of various forms of the disease. A total of 195 patients with the verified BPPD diagnosis were available for the examination. The fraction of the patients visiting the otoneurologist's office with complaints of this conditions is estimated at 17.8%. It was shown that the women suffer from benign paroxysmal positional vertigo 1.8 times more frequently than the men. The mean age of the patients of either sex experiencing this problem is above 50 years. Most of them have idiopathic pathology. The relationship between benign paroxysmal positional vertigo and vascular neurological disorders or inner and middle ear diseases remains to be elucidated. The present study also included the assessment of the effectiveness of the combination of various repositioning maneuvers, self-assisted vestibular gymnastics in the domestic environment, and training in long lying on the unaffected side.