Benign paroxysmal positional vertigo and its management

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers. In recent years, specific therapeutic maneuvers have resulted in its effective treatment. In this paper the current knowledge of the pathogenesis, diagnosis, and treatment of BPPV as well as the authors' own clinical experience in treating such patients are presented.

Material/methods: A retrospective review of the records of 204 patients with BPPV was performed. Epidemiological data and results from the audiological and neuro-otological work-up were recorded. All patients were treated with an appropriate repositioning maneuver, depending on the type of BPPV.

Results: Of the 204 patients, 163 had posterior canal involvement, 19 had horizontal canal involvement, and 6 had the anterior canal variant. Another 11 patients had bilateral posterior canal involvement and 5 had disease of two canals. The canalith repositioning procedure was immediately successful in 165 patients and in 23 more patients proved successful after its repetition in a second session, resulting in a total success rate of 92.1%.

Conclusions: Most of the patients with BPPV responded very well to treatment. However, differential diagnosis of the type of BPPV was necessary to apply the appropriate canalith repositioning procedure. The canalith repositioning procedure is easy and safe to perform, is noninvasive, can be repeated if needed, and can provide rapid relief of vertigo.