The canalith repositioning maneuver in patients with benign positional vertigo

2000 ◽  
Vol 257 (3) ◽  
pp. 133-136 ◽  
Author(s):  
T. Dal ◽  
L. N. Özlüoğlu ◽  
N. T. Ergin
Keyword(s):  
Positional Vertigo ◽  
Repositioning Maneuver

A Randomized, Controlled Assessment of the Canalith Repositioning Maneuver

1994 ◽  
Vol 110 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Brian W. Blakley
Keyword(s):  
Randomized Trial ◽  
Substantial Improvement ◽  
Subjective Improvement ◽  
Control Groups ◽  
Treatment Benefit ◽  
Control Subjects ◽  
Randomized Controlled ◽  
Positional Vertigo ◽  
And Control ◽  
Repositioning Maneuver

The efficacy of the canalith repositioning maneuver in the treatment of benign positional vertigo was assessed in this controlled, randomized trial of 38 subjects. Treated subjects underwent the maneuver and control subjects did not. All were reevaluated 1 month after treatment. The number of persons experiencing subjective improvement was not statistically significantly different between the treatment and control groups. All patients, in both experimental and control groups, in this study experienced substantial improvement. Although the maneuver is safe it does not have treatment benefit for benign positional vertigo.

scholarly journals Residual dizziness after successful repositioning maneuver for idiopathic benign paroxysmal positional vertigo: a review

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Giorgia Giommetti ◽  
Ruggero Lapenna ◽  
Roberto Panichi ◽  
Puya Dehgani Mobaraki ◽  
Fabrizio Longari ◽  
...  
Keyword(s):  
English Language ◽  
Benign Paroxysmal Positional Vertigo ◽  
Early Recognition ◽  
The Elderly ◽  
Vestibular Disorder ◽  
Risk Of Falling ◽  
Search Terms ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

The benign paroxysmal positional vertigo (BPPV) is a vestibular disorder cause of vertigo. The BPPV may be corrected mechanically by repositioning maneuvers but even after successful maneuvers, some patients report residual dizziness for a certain period afterward. Early recognition and treatment might decrease the incidence of residual dizziness in patients with BPPV, especially in those patients with psychiatric comorbidities and in the elderly, lowering the risk of falling. Many pathogenetic hypotheses for residual dizziness are under debate. The purpose of this review was to identify, evaluate and review recent researches about possible causal factors involved in residual dizziness and the implications on clinical practice. A literature search was performed using different databases such as Pubmed and Scopus. The following search terms were used: <em>residual dizziness, otolithic membrane and BPPV</em>. The search found a total of 1192 titles, which were reduced to 963 after a procedure of de-duplication of the found titles. The research was then restricted to an interval of time comprised between 2000 and 2016 for a total of 800 titles. Among these titles, only those including the terms <em>benign paroxysmal positional vertigo</em> were considered eligible for this review. Only publications in English language were taken into consideration and we excluded those with not available abstract. Finally, 90 abstracts were obtained and critically evaluated by two different Authors, and additional studies were identified by hand searching from the references of artiche of interest. Only 53 were included in this work.

Particle Repositioning Maneuver for Benign Paroxysmal Positional Vertigo

1993 ◽  
Vol 102 (5) ◽  
pp. 325-331 ◽  
Author(s):  
Lorne S. Parnes ◽  
R. Greg Price-Jones
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Poor Response ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Lost To Follow Up ◽  
Repositioning Maneuver ◽  
Simple Bedside ◽  
Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is a common, most often self-limited, vestibular end organ disorder that in some cases may be quite disabling. Recent evidence suggests that some, if not most, cases result from free-floating posterior semicircular canal endolymph particles. We postulate that the particle repositioning maneuver displaces these particles from the posterior canal through the common crus into the utricle, where they no longer induce pathologic responses. Our report focuses on 38 consecutive patients treated with this simple bedside technique during a 10-month period. On follow-up, 26 patients (68.4%) were free of disease, 4 (10.5%) were significantly improved, 4 (10.5%) remained unchanged, and 4 (10.5%) were lost to follow-up. Of the 4 patients who remained unchanged, 2 underwent successful posterior semicircular canal occlusions. The direction of the nystagmus during the second stage of the maneuver appears important in predicting the efficacy, with reversal of nystagmus denoting a poor response. These findings provide additional insight into the pathophysiology of this disorder.

scholarly journals Post-BPPV Syndrome: Our Experience in a Specialized Neurotology Clinic in Kolkata

2019 ◽  
Vol 02 (01) ◽  
pp. 01-09
Author(s):  
Anirban Biswas ◽  
Nilotpal Dutta
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Function ◽  
Poor Quality ◽  
Positional Vertigo ◽  
The Common ◽  
Vestibular Deficit ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Abstract Introduction The common cause of approximately 25 to 30% of all patients presenting to the neurotologist with the complaint of head-spinning is benign paroxysmal positional vertigo (BPPV) that is the commonest cause for which a patient attends a vertigo clinic. Though BPPV is very effectively treated with the canalith repositioning maneuver (CRM), a considerable percent of these patients (34–61% as per different studies)7 8 9 10 is not completely symptom-free even after a very successful maneuver (s) and complain of a new set of symptoms of light-headedness, unsteadiness, or dizziness or a combination of them termed as post-BPPV syndrome or as residual dizziness (RD) after successful correction of BPPV. Post-BPPV syndrome induces a very poor quality of life and is very incapacitating to most patients who suffer from it. Materials and Methods In Vertigo and Deafness Clinic, Kolkata, a total number of 200 patients were diagnosed with geotropic variety of BPPV in a period of 1 year from April 1, 2018 to March 31, 2019. Out of these 200 patients, the study was conducted on 178 patients who came for follow-up and also underwent all the necessary vestibular function tests. The remaining 22 patients who did not turn up for follow-up or did not undergo the tests either due to financial constraints or lack of time were excluded from the study group. The study was limited only to patients who had geotropic nystagmus and in patients with ageotropic nystagmus who were excluded from the study. One hundred seventy-eight patients of BPPV who were included in the study were managed by a protocol elaborated below devised by the first author. Results Following this protocol of BPPV management, only 23 (13%) patients after successful CRM presented with post-BPPV syndrome that is much less than the international figures of 34 to 61%. Analysis of data also showed that there was a huge psychic component in post-BPPV syndrome and that there was practically no organic vestibular deficit in post-BPPV syndrome. Conclusion Following our protocol of management of BPPV patients, which does not involve any new maneuver, only 13% of the patients complained of RD after the successful repositioning maneuvers. This is far lesser than the published international figures and this protocol may hence be tried and followed by other neurotology centers too. This protocol drastically reduces the morbidity of patients after the BPPV has been corrected by the requisite maneuvers. In our group of 23 patients who had post-BPPV syndrome out of 178 patients who had BPPV, the symptoms subsided spontaneously without medication within 3 weeks in more than 70% of patients. Only in three (13%) patients of post-BPPV syndrome, the RD persisted up to 12 weeks where drugs (selective serotonin reuptake inhibitor, benzodiazepines) and professional psychological counseling were required. None of these patients required any vestibular sedatives or the so called antivertigo drugs for amelioration of symptoms. It may hence be concluded that management of BPPV by this protocol reduces the incidence of post-BPPV syndrome and that antivertigo drugs have no role in the management of post-BPPV syndrome.

Dizziness

2016 ◽  
Author(s):  
Joshua N. Goldstein
Keyword(s):  
Physical Examination ◽  
Treatment Options ◽  
Symptomatic Therapy ◽  
Emergency Setting ◽  
Vestibular Disorders ◽  
Common Condition ◽  
Positional Vertigo ◽  
Associated Symptoms ◽  
Inner Ear Disease ◽  
Repositioning Maneuver

Dizziness is a relatively common condition in the emergency setting. Patient descriptions of their symptoms can be vague and inconsistent. This review highlights the most important aspects of the history and physical examination that can help differentiate among different causes of dizziness. In addition, it covers the pathophysiology of inner ear disease, including diagrams of vestibular anatomy. For the history, it is critical to capture dizziness, duration, triggers for dizziness, and associated symptoms. For the physical examination, a focused neurologic assessment is important, including balance, coordination, as well as an oculomotor assessment. For treatment of benign positional vertigo, various canalith repositioning maneuvers are described and diagrams shown. For vestibular neuritis, treatment options including vestibular rehabilitation and steroids are discussed. Finally, medical options for symptomatic therapy are listed.  Key words: Dizziness, benign positional vertigo, canalith repositioning maneuver, vestibular disorders. This review contains 7 highly rendered figures, 7 tables, and 40 references.

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