Experience With Epley's Manoeuvre and Vestibular Habituation Training in Benign Paroxysmal Positional Vertigo

Abstract

The most frequent vestibular disorder is benign paroxysmal positional vertigo. In almost all patients it occurs spontaneously and mainly through involvement of the posterior semicircular canal. Treatment consists in vestibular habituation training and in canalith repositioning manoeuvres. A retrospective review of patient files between 1999 to 2001 evaluated those diagnosed as having BPPV due to the posterior semicircular canal in order to compare the response to treatment with vestibular habituation training and with Epley's manoeuvre. The cases are described and analyzed and their response to treatment is compared using Fisher's exact test. The percentage of success with Epleys manoeuvre was 100 %. Eighty-two per cent of patients responded in the first seven days after the first manoeuvre. Relapses occurred in 17.6 %. With vestibular habituation training, a success rate of 90 % was obtained in the first month, and this decreased to 80 % by the end of the second and third months. Significant differences between the two therapeutic modalities were only visible at the conclusion of the first seven days of treatment (P=.01). The evident advantage with Epley's manoeuvre is that it greatly reduces the time required to obtain a satisfactory result. In addition, it allows patients to return quickly to their daily activities and improves their quality of life.