Diagnosis and treatment of 318 benign paroxysmal positional vertigo cases

Abstract

To investigate the diagnosis, treatment and therapeutic effect of various types of BPPV. Three hundred and eighteen BPPV patients were retrospectively analyzed. After the types of BPPV were determined by nystagmus characteristics provoked by positioning test, the appropriate repositioning maneuvers were performed. For patients unresponsive to initial treatment, a repetitive treatment was given after seven days. If patients failed after three continuous treatments, other therapeutic methods were chosen and performed. Overall effectiveness in the next three months after treatment was observed. Of 318 patients, 221 (69.5%) with posterior semicircular canal involvement, Epley repositioning maneuver was performed; 62 (19.5%) with horizontal semicircular canal involvement, Barbecue maneuver combined forced prolonged position maneuver were applied; 23 (7.2%) with anterior canal involvement were treated with Epley maneuver; 12 (3.8%) had the mixed type and were treated with corresponding repositioning maneuvers. After one week the total improvement rate was 82.1% (261/318) and 91.8% three months later (292/318). The different BPPV variants can be diagnosed according to the nystagmus characteristics during the appropriate provoking maneuvers, and appropriate repositioning maneuvers is a very effective method which can shorten disease period and relieve the symptoms. The method is easy to apply and could be widely performed clinically.