Benign paroxysmal positional vertigo and motion sickness

Symptomatology of Benign Paroxysmal Positional Vertigo (BPPV) is known to have great inter-divisional variability and different impact on patients’ quality of life (QoL). It has been observed that subjects suffering from pre-existing Motion Sickness (MS) experience more severe symptoms at the onset of the disease and have a worse course despite the success of the treatment with the canalith repositioning procedure (CRP). The aim of this study was to verify whether the BPPV symptomatology is different in patients with pre-existing MS and how much this condition adversely affects QoL. To recognize and quantify the presence of the pre-existing MS, the Motion Sickness Susceptibility Questionnaire-short (MSSQ-short) was proposed; to quantify the QoL, the Italian version of the Dizziness Handicap Index (DHI-I) questionnaire was proposed. We selected 43 patients with unilateral idiopathic BPPV who responded positively to a single CRP. Based on the responses of the MSSQ-short, 17 patients had a moderate degree MS. The data collect from these patients was compared with those from 26 patients without MS. The average DHI-I score of MS patients collected in the first evaluation before the CRP was 55.4 (min 20 and max 92), while in patients without MS it was 37.5; the difference was statistically significant (p = 0.014). Both groups showed a significant reduction in the total DHI-I score after the successful CRP, although the scores in the two groups remained significantly different (p 0.004). The differences in the DHI-I values between the two groups after 15 and 30 days were not statistically significant. The results of this study show that patients suffering from MS in our sample had a more intense symptomatology compared to patients not affected by pre-existent MS. Therefore, we suggest identifying MS during the anamnestic data collection, as for these patients the CRP may not be able to fully alleviate the dizzying symptoms. These conclusions have implications for the therapeutic and pharmacological strategy aimed at controlling MS, and at intervening more effectively on BPPV symptoms.