Efficacy of treatments for posterior canal benign paroxysmal positional vertigo

Laryngoscope. 1999 Apr;109(4):584-90. doi: 10.1097/00005537-199904000-00012.


Objective: This study was performed to determine the relative effectiveness of several passive head maneuvers for treating benign paroxysmal positional vertigo.

Study design: This prospective study used 87 subjects diagnosed by their physicians with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal.

Methods: Subjects were randomly assigned to three treatment groups: modified Epley maneuver, modified Epley maneuver with augmented head rotations, and modified Semont maneuver. They were interviewed 1 week after receiving one maneuver. If subjects desired further treatment, they were treated again with the same maneuver, a methodology repeated until subjects desired no further treatment; they were telephoned 3 and 6 months after the last treatment.

Results: The groups did not differ significantly, but subjects decreased significantly on vertigo intensity and frequency and improved significantly on independence in activities of daily living. Before treatment, tasks requiring pitch rotations of the head induced vertigo; common comorbid conditions were osteoporosis, cervical spine problems, and head trauma.

Conclusions: These data suggest that augmented head rotations are unnecessary and that the modified Epley and Semont maneuvers are equally effective in the remediation of vertigo in this population.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Craniocerebral Trauma / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / diagnosis
  • Posture*
  • Prospective Studies
  • Semicircular Canals / physiopathology
  • Severity of Illness Index
  • Spinal Diseases / diagnosis
  • Treatment Outcome
  • Vertigo / diagnosis
  • Vertigo / physiopathology
  • Vertigo / therapy*