BPPV and variants: improved treatment results with automated, nystagmus-based repositioning.
OBJECTIVE
Although classical benign paroxysmal positional vertigo has generally been resolvable by routine manual repositioning maneuvers, nevertheless resistant cases and variants remain a significant problem. We investigated the efficacy of analyzing and treating positional vertigo with a system that provides unlimited, automated maneuverability of the patient while maintaining constant electronic monitoring of nystagmus.


METHODS
A power-driven, multi-axial positioning chair combined with ongoing infrared video-oculography was used to manage 986 subjects in a tertiary clinical setting with complaints of positional vertigo. A nystagmus-based strategy and condition-specific protocols were used.


RESULTS
Significantly enhanced treatment outcomes were achieved, especially regarding intransigent and variant forms. Pertinent correlations were noted.


CONCLUSIONS
This multi-axial positioning chair combination provided enhanced diagnostic and treatment capabilities for managing positional vertigo, apparently due to improved analytical capability, precision repeatability, and unlimited 360-degree maneuverability.


CONCLUSIONS
This advancement should be considered for tertiary management of complicated labyrinthine lithiasis.
Nakayama
Meiho
M
Department of Otorhinolaryngology, Aichi Medical University, Aichigun, Japan. nakayama@aichi-med-u.ac.jp
Epley
John M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004584:Electronystagmography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011187:Posture; D016896:Treatment Outcome; D014717:Vertigo / Q000150:complications / Q000503:physiopathology / Q000628:therapy*