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Does the use of betahistine dihydrochloride affect positional nystagmus?

Yıl 2022, Cilt: 27 Sayı: 1, 45 - 48, 29.01.2022

Beyza Aslan Hasan Demirhan İlknur Yasak Özgür Yiğit Yıldırım Bayazıt

https://doi.org/10.21673/anadoluklin.880003

Öz

Aim: In this study, we aimed to investigate the effect of betahistine dihydrochloride (BD) use on positional nystagmus as an objective criterion for the diagnosis of benign paroxysmal positional vertigo (BPPV).


Methods: The retrospective study included 59 patients (15 males, 44 females) who were aged between 18 and 80 years and referred with suspected BPPV to the otorhinolaryngology clinic of the Istanbul Training and Research Hospital. Only patients who had no central pathology on oculomotor tests were included. Of the patients included, those not using BD were classified as Group I and those using BD medication (24 mg/day) within the last 48 hours as Group II. The positional nystagmus latency, duration, and slow-phase velocity (SPV) values were compared using videonystagmography.


Results: There was no significant difference between the two groups in terms of oculomotor gains (p>0.05). While there was no difference between the two groups in terms of positional nystagmus latency and SPV values, nystagmus duration was found to be significantly longer in Group II.


Conclusion: Although the BD use appears to prolong the duration of nystagmus in BPPV, it does not affect the other parameters of nystagmus, including SPV, and the prolonged duration is still within normal limits. Positional nystagmus can be investigated in patients with a history of suspected BPPV and BD prescription.

Anahtar Kelimeler

benign paroxysmal positional vertigo betahistine nystagmus

Destekleyen Kurum

-

Proje Numarası

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Teşekkür

-

Kaynakça

  • Bhattarcharyya N, Gubbels SP, Schwartz SR, Edlow JA, el-Kashlan H, Fife T, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156:1–47.
  • Parnes LS, Agrawal SK. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169:681–93.
  • Fernandez PN, Lopez MM, Huarte RM. Vestibulo-ocular reflex in patients with superior semicircular canal benign paroxysmal positional vertigo (BPPV). Acta Otolaryngol. 2014;134:485–90.
  • Lopez-Escamez JA, Molina MI, Gamiz MJ. Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating nystagmus. Am J Otolaryngol. 2006;27:173–8.
  • Papageorgiou E, McLean RJ, Gottlob I. Nystagmus in childhood. Pediatr Neonatol. 2014;55:341–51.
  • Bronstein AM, Patel M, Arshad Q. A brief review of the clinical anatomy of the vestibular-ocular connections—how much do we know?. Eye. 2015;29:163–70.
  • von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res. 2015;25:105–17.
  • Alcocer RR, Rodríguez JGL, Romero AN, Nuñez JLC, Montoya VR, Deschamps JJ, et al. Use of betahistine in the treatment of peripheral vertigo. Acta Otolaryngol. 2015;135:1205–11.
  • Dolatabadi AA, Larimi SR, Safaie A. Oral piracetam vs betahistine in outpatient management of peripheral vertigo: a randomized clinical trial. Arch Acad Emerg Med. 2019;7(1):e9.
  • Chen ZP, Zhang XY, Peng SY, Yang ZQ, Wang YB, Zhang YX, et al. Histamine H1 receptor contributes to vestibular compensation. J Neurosci. 2019;39:420–33.
  • Dutia MB. Betahistine, vestibular function and compensation: in vitro studies of vestibular function and plasticity. Acta Otolaryngol Suppl. 2000;544:11–4.
  • Lacour M, Sterkers O. Histamine and betahistine in the treatment of vertigo: elucidation of mechanisms of action. CNS Drugs. 2001;15:853–70.
  • Lamm K, Arnold W. The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic pO(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Hear Res. 2000;141:199–219.
  • Laurikainen E, Miller JF, Pyykkö I. Betahistine effects on cochlear blood flow: from the laboratory to the clinic. Acta Otolaryngol Suppl. 2000;544:5–7
  • Cavaliere M, Mottola G, Iemma M. Benign paroxysmal positional vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolaryngol Ital. 2005;25:107–12.
  • Oosterveld WJ. Effect of betahistine dihydrochloride on induced vestibular nystagmus: a double blind study. Clin Otolaryngol Allied Sci. 1987;12:131–5.
  • Kıroğlu M, Dağkıran M, Özdemir S, Sürmelioğlu Ö, Tarkan Ö. The effects of betahistine and dimenhydrinate on caloric test parameters; slow-phase velocity of nystagmus. J Int Adv Otol. 2014;10:68–71.
  • Yabe T, de Waele C, Serafin M, Vibert N, Arrang JM, Mühlethaler M, et al. Medial vestibular nucleus in the guinea-pig: histaminergic receptors. II. An in vitro study. Exp Brain Res. 1993;93:249–58.
  • Kingma H, Bonink M, Meulenbroeks A, Konijnenberg H. Dose-dependent effect of betahistine on the vestibulo-ocular reflex: a double-blind, placebo controlled study in patients with paroxysmal vertigo. Acta Otolaryngol. 1997;117:641–6.
  • Honrubia V, House M. Mechanism of posterior semicircular canal stimulation in patients with benign paroxysmal positional vertigo. Acta Otolaryngol. 2001;121:234–40.
  • Cullen JR, Hall SJ, Allen RH. Effect of betahistine dihydrochloride compared with cinnarizine on induced vestibular nystagmus. Clin Otolaryngol Allied Sci. 1989;14:485–7.
  • Lins U, Farina M, Kurc M, Riordana G, Thalmannd R, Thalmannd I. The otoconia of the guinea pig utricle: internal structure, surface exposure, and interactions with the filament matrix. J Struct Biol. 2000;131:67–78.
  • Jang YS, Hwang CH, Shin JY, Bae WY, Kim LS. Age-related changes on the morphology of the otoconia. Laryngoscope. 2006;116:996–1001.

Betahistin dihidroklorür kullanımı pozisyonel nistagmusu etkiler mi?

Yıl 2022, Cilt: 27 Sayı: 1, 45 - 48, 29.01.2022

Beyza Aslan Hasan Demirhan İlknur Yasak Özgür Yiğit Yıldırım Bayazıt

https://doi.org/10.21673/anadoluklin.880003

Öz

Amaç: Bu çalışmada betahistin dihidroklorür (BD) kullanımının benign paroksismal pozisyonel vertigo (BPPV) tanısında objektif kriter olan pozisyonel nistagmus üzerine etkisini incelemek amaçlanmıştır.


Yöntem: Retrospektif çalışmamız yaşları 18–80 yıl aralığında değişen ve BPPV şüphesiyle İstanbul Eğitim ve Araştırma Hastanesi’nin kulak–burun–boğaz polikliniğine yönlendirilen 59 (15 erkek, 44 kadın) hasta içerdi. Çalışmaya yalnızca okülomotor testlerde santral patoloji görülmeyen hastalar dahil edildi. Dahil edilen hastalardan BD kullanmayanlar Grup I, son 48 saat içinde BD grubu ilaç (24 mg/gün) kullananlar ise Grup II olarak tasnif edildi. Pozisyonel nistagmus latans, süre ve yavaş faz hızı (YFH) değerleri videonistagmografi kullanılarak karşılaştırıldı.


Bulgular: İki grup arasında okülomotor kazançlar bakımından anlamlı bir fark bulunmadı (p>0,05). Yine iki grup arasında pozisyonel nistagmus latans ve YFH değerleri açısından fark saptanmazken nistagmus süresi Grup II’de anlamlı olarak daha uzun bulundu.


Sonuç: BD kullanımı BPPV’de pozisyonel nistagmus süresini uzatıyor gibi görünse de YFH dahil diğer nistagmus parametrelerini etkilememektedir ve süredeki uzama halen normal sınırlar içindedir. BPPV şüphesi ve BD reçeteleme öyküsü olan hastalarda pozisyonel nistagmus araştırılabilir.

Anahtar Kelimeler

benign paroksismal pozisyonel vertigo betahistin nistagmus

Proje Numarası

-

Kaynakça

  • Bhattarcharyya N, Gubbels SP, Schwartz SR, Edlow JA, el-Kashlan H, Fife T, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156:1–47.
  • Parnes LS, Agrawal SK. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169:681–93.
  • Fernandez PN, Lopez MM, Huarte RM. Vestibulo-ocular reflex in patients with superior semicircular canal benign paroxysmal positional vertigo (BPPV). Acta Otolaryngol. 2014;134:485–90.
  • Lopez-Escamez JA, Molina MI, Gamiz MJ. Anterior semicircular canal benign paroxysmal positional vertigo and positional downbeating nystagmus. Am J Otolaryngol. 2006;27:173–8.
  • Papageorgiou E, McLean RJ, Gottlob I. Nystagmus in childhood. Pediatr Neonatol. 2014;55:341–51.
  • Bronstein AM, Patel M, Arshad Q. A brief review of the clinical anatomy of the vestibular-ocular connections—how much do we know?. Eye. 2015;29:163–70.
  • von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res. 2015;25:105–17.
  • Alcocer RR, Rodríguez JGL, Romero AN, Nuñez JLC, Montoya VR, Deschamps JJ, et al. Use of betahistine in the treatment of peripheral vertigo. Acta Otolaryngol. 2015;135:1205–11.
  • Dolatabadi AA, Larimi SR, Safaie A. Oral piracetam vs betahistine in outpatient management of peripheral vertigo: a randomized clinical trial. Arch Acad Emerg Med. 2019;7(1):e9.
  • Chen ZP, Zhang XY, Peng SY, Yang ZQ, Wang YB, Zhang YX, et al. Histamine H1 receptor contributes to vestibular compensation. J Neurosci. 2019;39:420–33.
  • Dutia MB. Betahistine, vestibular function and compensation: in vitro studies of vestibular function and plasticity. Acta Otolaryngol Suppl. 2000;544:11–4.
  • Lacour M, Sterkers O. Histamine and betahistine in the treatment of vertigo: elucidation of mechanisms of action. CNS Drugs. 2001;15:853–70.
  • Lamm K, Arnold W. The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic pO(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Hear Res. 2000;141:199–219.
  • Laurikainen E, Miller JF, Pyykkö I. Betahistine effects on cochlear blood flow: from the laboratory to the clinic. Acta Otolaryngol Suppl. 2000;544:5–7
  • Cavaliere M, Mottola G, Iemma M. Benign paroxysmal positional vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolaryngol Ital. 2005;25:107–12.
  • Oosterveld WJ. Effect of betahistine dihydrochloride on induced vestibular nystagmus: a double blind study. Clin Otolaryngol Allied Sci. 1987;12:131–5.
  • Kıroğlu M, Dağkıran M, Özdemir S, Sürmelioğlu Ö, Tarkan Ö. The effects of betahistine and dimenhydrinate on caloric test parameters; slow-phase velocity of nystagmus. J Int Adv Otol. 2014;10:68–71.
  • Yabe T, de Waele C, Serafin M, Vibert N, Arrang JM, Mühlethaler M, et al. Medial vestibular nucleus in the guinea-pig: histaminergic receptors. II. An in vitro study. Exp Brain Res. 1993;93:249–58.
  • Kingma H, Bonink M, Meulenbroeks A, Konijnenberg H. Dose-dependent effect of betahistine on the vestibulo-ocular reflex: a double-blind, placebo controlled study in patients with paroxysmal vertigo. Acta Otolaryngol. 1997;117:641–6.
  • Honrubia V, House M. Mechanism of posterior semicircular canal stimulation in patients with benign paroxysmal positional vertigo. Acta Otolaryngol. 2001;121:234–40.
  • Cullen JR, Hall SJ, Allen RH. Effect of betahistine dihydrochloride compared with cinnarizine on induced vestibular nystagmus. Clin Otolaryngol Allied Sci. 1989;14:485–7.
  • Lins U, Farina M, Kurc M, Riordana G, Thalmannd R, Thalmannd I. The otoconia of the guinea pig utricle: internal structure, surface exposure, and interactions with the filament matrix. J Struct Biol. 2000;131:67–78.
  • Jang YS, Hwang CH, Shin JY, Bae WY, Kim LS. Age-related changes on the morphology of the otoconia. Laryngoscope. 2006;116:996–1001.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORJİNAL MAKALE
Yazarlar

Beyza Aslan 0000-0003-3650-182X

Hasan Demirhan 0000-0002-2047-0881

İlknur Yasak Bu kişi benim 0000-0002-0035-5173

Özgür Yiğit 0000-0003-1731-3233

Yıldırım Bayazıt 0000-0002-3887-4569

Proje Numarası -
Yayımlanma Tarihi 29 Ocak 2022
Kabul Tarihi 12 Ekim 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 27 Sayı: 1

Kaynak Göster

Vancouver Aslan B, Demirhan H, Yasak İ, Yiğit Ö, Bayazıt Y. Does the use of betahistine dihydrochloride affect positional nystagmus?. Anadolu Klin. 2022;27(1):45-8.
 Kapak Resmi İndir

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