Abstract Introduction Vestibular otolith function plays a major role in balance control. Objective To investigate the saccular and balance functions of children with Down syndrome (DS). Methods In total, 15 children with DS aged between 9 and 11 years were included. An age- and gender-matched control group (CG) composed of 15 normal participants was also included. The subjects with DS had trisomy 21, without hearing or organic problems, and they had independence in stance. The saccular function among the children with DS and among the controls was tested using air-conduction cervical vestibular-evoked myogenic potentials (cVEMPs). In addition, the static and dynamic balance statuses were evaluated using the following assessments; the Pediatric Balance Scale (PBS), the modified Clinical Test of Sensory Interaction on Balance (mCTSIB), the Romberg test, and the Timed Up and Go (TUG) test. Results In the present study, the results of the saccular function test showed that there was a significant difference between children with and without DS (p < 0.05). The DS subjects had significantly earlier N1 latancy and lower amplitude of the cVEMPs (< 70 μV) compared with the control subjects. The static-dynamic balance ability was statistically and significantly different in children with DS compared with the controls (p < 0.05). Conclusion These results revealed that saccular function seems to be affected in DS subjects. The dysfunction in static and dynamic balance abilities of the children with DS may be attributed to vestibular dysfunction as well as low gross motor skills. This knowledge should be taken into account when assessing motor performance in those subjects. Additional larger studies testing other dimensions of the vestibular system in children with DS are needed.

Resumo Introdução: A vertigem posicional paroxística benigna (VPPB) é uma síndrome clínica propostamente causada por detritos utriculares desprendidos dentro dos canais semicirculares. Embora a maioria dos pacientes seja tratada com uma ou duas manobras de reposicionamento, alguns pacientes precisam de manobras repetidas para o alívio dos sintomas. Objetivo: O objetivo deste estudo foi investigar os fatores associados a pacientes com VPPB que precisam de vários procedimentos de reposicionamento para o tratamento. Método: Os dados foram obtidos a partir de prontuários médicos de 153 pacientes diagnosticados com VPPB e tratados. Os pacientes foram tratados com manobras de reposicionamento. Os dados demográficos e fatores, incluindo idade, sexo, tipo de canal, duração dos sintomas, comorbidades e número de manobras de reposicionamento para alívio, foram registrados para análise estatística. Resultados: Idade, sexo, tipo de canal e a duração dos sintomas não tiveram impacto sobre o número de manobras. A comorbidade mais comum foi problemas de coluna. Hipertensão foi a única comorbidade significantemente associada ao aumento do número de manobras. Conclusão: A presença de hipertensão é um fator de risco para necessidade de manobras repetidas no tratamento da VPPB. Os médicos devem estar cientes do aumento da probabilidade de manobras de reposicionamento repetidas nesse grupo de pacientes. O papel das comorbidades e dos fatores vasculares precisa ser mais bem esclarecido no curso da VPPB.

ABSTRACT INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) is a clinical syndrome that is proposed to be caused by dislocated utricular debris into semicircular canals. Although the majority of patients are treated by one or two repositioning maneuvers, some of the patients need repeated maneuvers for relief. OBJECTIVE: The goal of this study was to investigate the factors associated with patients with benign paroxysmal positional vertigo who required multiple repositioning procedures for treatment. METHODS: Data were obtained from the clinical records of 153 patients diagnosed with benign paroxysmal positional vertigo. Patients were treated by repositioning maneuvers. Demographic data and the factors including age, sex, canal type, duration of symptoms, comorbidities and number of repositioning maneuvers for relief were documented for statistical analysis. RESULTS: Age, sex, canal type and the duration of symptoms had no impact on the number of maneuvers. The most common comorbidity was spine problems. Hypertension was the only comorbidity that significantly associated with increased number of maneuvers. CONCLUSION: The presence of hypertension is a risk factor for repeated maneuvers in benign paroxysmal positional vertigo treatment. Physicians should be aware of the increased probability of repeated repositioning maneuvers in these group of patients. The role of comorbidities and vascular factors need to be further clarified in the course of benign paroxysmal positional vertigo.