Repeated vs single physical maneuver in benign paroxysmal positional vertigo

Acta Neurol Scand. 2004 Sep;110(3):166-9. doi: 10.1111/j.1600-0404.2004.00296.x.

Abstract

Objectives: To evaluate the effectiveness and possible side effects of a single session of repeated particle repositioning maneuver (PRM) to treat posterior canal benign paroxysmal positional vertigo (BPPV) and the usefulness of post-treatment restrictions.

Materials and methods: A total of 125 consecutive patients with idiopathic BPPV participated in the study. Fifty patients received a single session of repeated PRM only (group I). Results were compared with those of 50 patients with BPPV who received a single PRM (group IIb), and 25 patients who received a single PRM followed by the use of a neck collar and keeping the head upright for 48 h (group IIa).

Results: Forty-six patients (92%) of group I, 40 patients (80%) of group IIb, and 21 patients (84%) of group IIa were completely free of signs and symptoms when re-examined 1 week after treatment. Transient nausea and disequilibrium following treatment were reported equally in all subgroups and well tolerated. Nearly all patients of group IIa considered the post-treatment restrictions very inconvenient.

Conclusions: A single session of repeated physical procedure seems to be clinically superior to one single maneuver and well tolerated. Additional post-treatment measurements are inconvenient and should be abandoned.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Braces
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / adverse effects
  • Musculoskeletal Manipulations / methods*
  • Musculoskeletal Manipulations / statistics & numerical data
  • Otolithic Membrane / pathology
  • Otolithic Membrane / physiopathology*
  • Recovery of Function / physiology
  • Saccule and Utricle / pathology
  • Saccule and Utricle / physiopathology*
  • Semicircular Canals / pathology
  • Semicircular Canals / physiopathology*
  • Treatment Outcome
  • Vertigo / pathology
  • Vertigo / physiopathology
  • Vertigo / therapy*