Evaluation of treatment in benign paroxysmal positional vertigo (BPPV)

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. The prognosis is good, usually with spontaneous remission within three months, but symptoms may last. Patients were consecutively evaluated before and 1, 6 and 12 months after treatment, to evaluate the long-term effects of the Semont manoeuvre and Brandt & Daroff exercises. The subjects were 17 patients (13 women and four men, mean age 52 years) who had suffered from BPPV for more than three months. The Semont manoeuvre was performed. Patients with vertigo after two Semont manoeuvres were instructed to perform Brandt & Daroff exercises. Follow-up was done by the Dix–Hallpike test, measurement of static/dynamic balance and a health questionnaire; for the vertigo, a visual analogue scale (VAS) was used. Three of 17 patients still suffered from vertigo after 12 months but the nystagmus during the Dix–Hallpike test was significantly decreased. At the end of the study, nine of 17 patients still experienced unsteadiness during standing and walking. It is of importance to perform not only manoeuvres and Brandt & Daroff exercises but also to instruct the patient in vestibular rehabilitation including static/dynamic balance exercises in order to reduce unsteadiness.

• Benign paroxysmal positional vertigo
• BPPV
• Brandt & Daroff exercises
• Dix–Hallpike test
• Semont manoeuvre
• static/dynamic balance tests