Management of 210 patients with benign paroxysmal positional vertigo: AMC protocol and outcomes

Abstract

Conclusion: Benign paroxysmal positional vertigo (BPPV) could be treated with specific maneuvers for the involved canals. Management on a daily basis gave earlier relief than weekly treatment, especially in apogeotropic BPPV. Apogeotropic and multi-canal BPPVs were related to the increased numbers of follow-ups and trauma was related to the increased recurrence. Objective: We aimed to report the short-term outcomes of our protocol for BPPV and evaluate the factors influencing the results and recurrence. Methods: In 210 BPPV patients, posterior semicircular canal (PSCC), geotropic and apogeotropic lateral canal BPPVs were treated with the Epley maneuver, barbecue maneuver, and barbecue maneuver after head-shaking. The total number of follow-ups needed to have no provoked nystagmus, success rates at 1 week and 1 month, and factors for repeated maneuvers or recurrence were identified. Results: Apogeotropic and multi-canal BPPV needed more follow-ups than PSCC BPPV. Multi-canal BPPV showed a significantly lower 1-week success rate than other types. Anterior and multi-canal BPPV showed significantly lower 1-month success rates than other types. The 1-week success rates for PSCC and geotropic and apogeotropic BPPV in patients followed up on a daily basis were higher than those in patients with weekly follow-up and the difference was significant only in apogeotropic BPPV. The overall 1-year recurrence rate was 16% and higher recurrence rate was related to trauma.