Treatment outcome of two different methods of canalith repositioning maneuver

ABSTRACT

BACKGROUND AND OBJECTIVES: Canalith repositioning procedure described by Epley is an effective treatment of benign paroxysmal positional vertigo (BPPV) based on the theory of canalithiasis. Although there are many modifications of Epley's maneuver, they have much similarity and are usually composed of 4 steps. However there is considerable variation of pause at each position from 6 seconds to 4 minutes. The purpose of this study is to determine treatment outcome of short and long pause at each position. MATERIALS AND METHODS: This is a randomized prospective study of patients with posterior canal type BPPV. One hundred patients were randomized to one of two groups at their first clinic visit between March 1999 and September 2000. The diagnosis was based on typical findings of vertigo and nystagmus by Dix-Hallpike maneuver and head turning in supine position. The authors treated patients with two different methods of the canalith repositioning procedure. One group maintained each position until the nystagmus stopped. If no nystagmus was observed, the position was maintained for 5 to 10 seconds. The other group maintained each position for 3 minutes. We assessed treatment outcomes of two methods. RESULTS: We can not find the difference of a success rate between two groups. CONCLUSION: It takes less than one minute with rapid head position changing method, so this method is more feasible in out-patients clinics.