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 • Nystag I 1978 Motorola 6800 CPU • 1. EQUILIBRIUM MICRO IN SCANDINAVIA • 4 CHANNELS, PATTERN RECOGNITION PRINCIPLE • SAMPLING FREQUENCY 200 HZ • IN CLICAL USE
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 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
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 • 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 • • 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
THE DISTRIBUTION OF SYMPTOMS IN THE POPULATION ”THE EVENT HORIZON” CLINICAL VERTIGO DIZZINESS N
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 • • • 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 • 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 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 • The decrease of systolic blood pressure 20 mm. Hg • The decrease of diastolic blood pressure 12 mm Hg • See Table below for more information
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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