Effectiveness of the canalith repositioning procedure in idiopathic and posttraumatic benign paroxysmal positional vertigo

Background. Vertigo as a symptom accompanies many pathological processes leading to damage of the vestibular system at a peripheral or central level. It is a manifestation of systemic diseases. Vertigo is one of the most common causes of presentation of the patient to a general practitioner. One of the most common causes of sudden vertigo is benign paroxysmal positional vertigo (BPPV).

Objectives. Assessment of the effectiveness of the canalith repositioning procedure in idiopathic and posttraumatic BPPV.

Material and methods. 50 people with BPPV aged 22–78 (mean 53 ± 13), divided into 2 groups of 25 subjects each, suffering from posttraumatic (group A, aged 53 ± 15) and idiopathic (group B, aged 53 ± 11) vertigo. The treatment was conducted using the Epley manoeuver, controlling its effectiveness by means of the Dix-Hallpike manoeuvre.

Results. All the treated patients benefited from the therapy. The percentage of patients cured after the first two medical manoeuvres was 52% (13) and 92% (23) in groups A and B, respectively, which is a statistically significant difference (p = 0.0016). Patients in group B had an 18 times higher chance of regression of symptoms as early as after the first medical manoeuvre. The number of performed manoeuvres which guaranteed full effectiveness was on average 1.16 per patient with only one semicircular canal affected, and 3.5 when semicircular canals on both sides were affected.

Conclusions. 1. The application of motor rehabilitation in the course of BPPV is a non-invasive method for treating vertigo with high effectiveness. 2. Trauma in medical history prolongs the treatment of BPPV using manoeuvre. 3. If BPPV affects both sides, the manoeuvre should be repeated more times. 4. The characteristic medical history and risk factors (trauma) facilitate forming a suspicion of the diagnosis with a high probability as early as in the office of a general practitioner.