BPPV and variants: improved treatment results with automated, nystagmus-based repositioning

Otolaryngol Head Neck Surg. 2005 Jul;133(1):107-12. doi: 10.1016/j.otohns.2005.03.027.

Abstract

Objective: Although classical benign paroxysmal positional vertigo has generally been resolvable by routine manual repositioning maneuvers, nevertheless resistant cases and variants remain a significant problem. We investigated the efficacy of analyzing and treating positional vertigo with a system that provides unlimited, automated maneuverability of the patient while maintaining constant electronic monitoring of nystagmus.

Study design and setting: A power-driven, multi-axial positioning chair combined with ongoing infrared video-oculography was used to manage 986 subjects in a tertiary clinical setting with complaints of positional vertigo. A nystagmus-based strategy and condition-specific protocols were used.

Results: Significantly enhanced treatment outcomes were achieved, especially regarding intransigent and variant forms. Pertinent correlations were noted.

Conclusion: This multi-axial positioning chair combination provided enhanced diagnostic and treatment capabilities for managing positional vertigo, apparently due to improved analytical capability, precision repeatability, and unlimited 360-degree maneuverability.

Significance: This advancement should be considered for tertiary management of complicated labyrinthine lithiasis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Electronystagmography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nystagmus, Pathologic / diagnosis
  • Nystagmus, Pathologic / etiology
  • Nystagmus, Pathologic / physiopathology*
  • Physical Therapy Modalities / instrumentation*
  • Posture
  • Treatment Outcome
  • Vertigo / complications
  • Vertigo / physiopathology
  • Vertigo / therapy*