Does vestibular habituation still have a place in the treatment of benign paroxysmal positional vertigo?

2000 ◽  
Vol 114 (7) ◽  
pp. 501-505 ◽  
Author(s):  
G. K. Banfield ◽  
C. Wood ◽  
J. Knight
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Response To Treatment ◽  
Positional Vertigo ◽  
Spine Pathology ◽  
Before And After ◽  
Traditional Therapies ◽  
High Level ◽  
Term Response ◽  
Paroxysmal Positional Vertigo

Particle repositioning procedures such as the Epley manoeuvre have become popular in the management of benign paroxysmal positional vertigo (BPPV) at the expense of more traditional therapies such as vestibular habituation.We prospectively analysed the response of consecutive patients presenting with BPPV to treatment with vestibular habituation exercises using a symptom score sheet before and after treatment. This same patient group was then followed up, on average three years, eight months after discharge, to determine their long-term response to treatment.The results of the study demonstrated an excellent short-term response rate to treatment but a high level of recurrence after discharge. Most patients who experienced further symptoms following discharge were however self-reliant and were able to return to their habituation exercises without the need for further medical input.The aim in the management of these patients must be to provide long-term self reliance as well as shortterm cure and it may be that this has not yet been well demonstrated with the Epley manoeuvre. It must also be remembered that particle repositioning manoeuvres cannot be used in all patients for example those who suffer with cervical or thoracic spine pathology and that some will fail to respond at all.We believe that vestibular habituation retains a useful role in the treatment of BPPV.

Argon laser irradiation of the semicircular canal in two patients with benign paroxysmal positional vertigo

2002 ◽  
Vol 116 (9) ◽  
pp. 723-725 ◽  
Author(s):  
Yasuya Nomura
Keyword(s):  
Laser Irradiation ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Argon Laser ◽  
Laser Device ◽  
Positional Vertigo ◽  
Long Term Follow Up ◽  
Paroxysmal Positional Vertigo

The results of long-term follow-up after surgical treatment of two patients with intractable benign paroxysmal positional vertigo are reported. Argon laser irradiation of the blue-lined posterior and lateral semicircular canals in one patient, and of only the posterior canal in the other was performed seven and six years ago, respectively. Argon laser irradiation was carried out 10 times in succession three mm along the canal to occlude it. The power applied each time was 1.5.W on the dial of the laser device for 0.5.sec. Relief of vertigo was noted on the second post-irradiation day. There has been no recurrence of vertigo in these patients.

Development of a physiotherapy-led balance clinic: the Aintree model

2014 ◽  
Vol 128 (11) ◽  
pp. 966-971 ◽  
Author(s):  
A V Kasbekar ◽  
N Mullin ◽  
C Morrow ◽  
A M Youssef ◽  
T Kay ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Benign Paroxysmal Positional Vertigo ◽  
Waiting Times ◽  
Clinic Visit ◽  
Positional Vertigo ◽  
One Stop ◽  
Set Up ◽  
High Level ◽  
Referral Letters ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To create a ‘one-stop’ clinic in which assessment, diagnosis, treatment and therapies for most patients presenting with balance and dizziness disorders are delivered simultaneously.Methods:Patients triaged via referral letters were selected to attend the balance clinic, which is led by specialist balance physiotherapists. Patients were seen by an audiologist, and a ‘balance’ ENT consultant was available for joint consultations when required. Further details of the clinic set up are discussed.Results:Over an 18-month period, 200 new ‘dizzy’ patients attended the clinic. Benign paroxysmal positional vertigo and labyrinthitis were the commonest diagnoses. Fifty per cent of all patients were discharged after a single clinic visit. Questionnaires showed that patient satisfaction was high.Conclusion:The physiotherapy-led balance clinic has reduced patient waiting times to be seen, has a high level of patient satisfaction and is economically beneficial.

Treatment of Objective and Subjective Benign Paroxysmal Positional Vertigo

2013 ◽  
Vol 24 (07) ◽  
pp. 600-606 ◽  
Author(s):  
Alexandra C. Huebner ◽  
Susan R. Lytle ◽  
Steven M. Doettl ◽  
Patrick N. Plyler ◽  
James T. Thelin
Keyword(s):  
Repeated Measures ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Subjective Report ◽  
Repeated Measures Design ◽  
Positional Vertigo ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Before And After ◽  
Paroxysmal Positional Vertigo

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in adults and is a result of otolithic particles or debris that become free floating within a semicircular canal or adhere to the cupula. Characteristics of BPPV include brief episodes of latent onset vertigo that occur with changes in head position, transient rotary nystagmus beating toward the dependent ear, and reversed nystagmus upon sitting up. Both the vertigo and nystagmus fatigue quickly while maintaining the same head position. The BPPV may be classified as objective or subjective. Objective BPPV presents all the aforementioned symptoms whereas subjective BPPV presents all the symptoms without nystagmus. The accepted method of treatment for objective BPPV is canalith repositioning maneuvers (CRM); however, CRM are not traditionally used as the method of treatment for cases of subjective BPPV. Purpose: The purpose of the study was to determine if the subjective report of dizziness using the Dizziness Handicap Inventory (DHI) was different in patients with objective and subjective BPPV and to determine if the two groups showed similar improvements in perceived dizziness handicap following CRM treatment. Research Design: The present study utilized a retrospective, repeated measures design. Study Sample: Sixty-three adults with BPPV that were given the DHI both before and after CRM treatment. Data Collection and Analysis: Pre and post DHI results were analyzed for participants with objective versus subjective BPPV. A five-question DHI subscale was also analyzed between the groups. Results: A significant difference was noted between initial and posttreatment DHI scores for patients in both the subjective and objective groups when using the full-scale and subscale DHI. No significant difference was noted between groups for their initial or posttreatment DHI scores. The two groups also did not differ significantly in their initial or posttreatment DHI subscale scores. Conclusions: The results of the study indicated that individuals with both objective and subjective BPPV demonstrated significant improvement in DHI scores following CRM treatment. Additionally, there was no difference in DHI improvement for the subjective versus objective group suggesting CRM are effective for both subjective BPPV and objective BPPV. This improvement in DHI scores was also noted in the five-question DHI subscale with no significant difference noted between groups. These findings combined with previous studies suggest the presence or absence of nystagmus during Dix-Hallpike maneuvers is not related to the effectiveness of treatment using CRM.

scholarly journals Effects of cranial osteopathic techniques in the symptoms of benign positional paroxistic vertical

2020 ◽  
Vol 18 ◽  
pp. 1-5
Author(s):  
Otávio Augusto do Nascimento Oliveira ◽  
Laiana Sepúlveda de Andrade Mesquita ◽  
Maurício Rocha Mendes ◽  
Lílian Maria Magalhães Costa de Oliveira ◽  
Laís Cristina Almeida
Keyword(s):  
Statistical Analysis ◽  
Benign Paroxysmal Positional Vertigo ◽  
Intervention Group ◽  
Control Group ◽  
Common Cause ◽  
A Value ◽  
Positional Vertigo ◽  
Before And After ◽  
Temporal Bones ◽  
Paroxysmal Positional Vertigo

Background: The benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness among the population. The osteopathy is a practice of manual therapy which is guided by a holistic perspective of human being, the cranial osteopathy affirms that the respective bones of the cranium represent mobility. Objective: To investigate the effect of the cranial osteopathy techniques on the benign paroxysmal positional vertigo. Methods: The current study included 20 female subjects, each one of them with benign paroxysmal positional vertigo, distributed in two groups, an intervention group and a control group (placebo); in order to detect the BPPV, was applied the Dix-Hallpike test before and after the interventions. Three techniques of cranial osteopathy were used on the structures related to vestibule and to the temporal bones: mobilization of temporal bones, tensioning of cerebellar tentorium and mobilization of eyeball. All statistical analyzes were performed using the GraphPad Prism 6.0 software (GraphPad Software, CA).Results: Among the intervention group, 7 of 10 individuals were negative to the Dix-Hallpike test, whilst individuals of the control group remained positive to the test. In the statistical analysis verified that the intervention with osteopathic techniques had a significant effect in compared to the control group, with a value p=0.0261. Conclusion: The cranial osteopathy appears to be able of produce effects on the vestibular activity, whereas were able to reduce, in a significant means, the symptoms concerning to BPPV.

Long-Term Postural Abnormalities in Benign Paroxysmal Positional Vertigo

ORL ◽  
2002 ◽  
Vol 64 (4) ◽  
pp. 237-241 ◽  
Author(s):  
Pier Giorgio Giacomini ◽  
Marco Alessandrini ◽  
Antonio Magrini
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Positional Vertigo ◽  
Postural Abnormalities ◽  
Paroxysmal Positional Vertigo
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