Repeated vs single physical maneuver in benign paroxysmal positional vertigo.
OBJECTIVE
To evaluate the effectiveness and possible side effects of a single session of repeated particle repositioning maneuver (PRM) to treat posterior canal benign paroxysmal positional vertigo (BPPV) and the usefulness of post-treatment restrictions.


METHODS
A total of 125 consecutive patients with idiopathic BPPV participated in the study. Fifty patients received a single session of repeated PRM only (group I). Results were compared with those of 50 patients with BPPV who received a single PRM (group IIb), and 25 patients who received a single PRM followed by the use of a neck collar and keeping the head upright for 48 h (group IIa).


RESULTS
Forty-six patients (92%) of group I, 40 patients (80%) of group IIb, and 21 patients (84%) of group IIa were completely free of signs and symptoms when re-examined 1 week after treatment. Transient nausea and disequilibrium following treatment were reported equally in all subgroups and well tolerated. Nearly all patients of group IIa considered the post-treatment restrictions very inconvenient.


CONCLUSIONS
A single session of repeated physical procedure seems to be clinically superior to one single maneuver and well tolerated. Additional post-treatment measurements are inconvenient and should be abandoned.
Department of Neurology, Meir General Hospital, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. cgordon@post.tau.ac.il
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Gordon
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Gadoth
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001915:Braces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D010037:Otolithic Membrane / Q000473:pathology / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology; D012444:Saccule and Utricle / Q000473:pathology / Q000503:physiopathology*; D012665:Semicircular Canals / Q000473:pathology / Q000503:physiopathology*; D016896:Treatment Outcome; D014717:Vertigo / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*