No more postural restrictions in posterior canal benign paroxysmal positional vertigo.
OBJECTIVE
To establish if postural restrictions are useful after repositioning maneuvers in posterior canal benign paroxysmal positional vertigo (BPPV).


METHODS
Prospective double-blind consecutive case study.


METHODS
This study was conducted at a tertiary referral hospital.


METHODS
Three hundred ninety-one consecutive patients diagnosed of posterior canal BPPV with a positive Dix-Hallpike test.


METHODS
Two hundred seven patients diagnosed during the first year of our study were instructed to follow postural restrictions after repositioning maneuvers, and 184 patients who were diagnosed in the second year of our study did not receive any postural restriction after treatment. All of them were reevaluated 10 days later, and they were followed up until their symptoms resolved.


METHODS
We compared the success rates of each treatment analyzing the number of maneuvers needed until symptoms resolved, recurrence rate, and subjective recovery at the end of treatment between both groups.


RESULTS
There were no statistical differences in number of maneuvers needed to resolve symptoms between patients who restricted their movements (80.2% of success with 1 maneuver) and those who did not (72.3%). Recurrence rate was not statistically different among groups (2.3 and 3.1%), and almost all patients declared to feel better after treatment in both groups (97.1 and 98.9%).


CONCLUSIONS
Efficacy of Epley maneuver is not improved by postural restrictions. Therefore, we do not recommend any postural restrictions to patients with posterior canal BPPV.
Casqueiro
Jose Carlos
JC
Department of Otolaryngology, Hospital Severo Ochoa, Leganes (Madrid), Spain. jccasqueiro.hsvo@salud.madrid.org
Ayala
Alejandra
A
Monedero
Gerardo
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011446:Prospective Studies; D014717:Vertigo / Q000503:physiopathology* / Q000628:therapy*