Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Humans ; Semicircular Canals ; Vertigo

OBJECTIVETo evaluate the efficacy of the modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo.

METHODSThe randomized controlled trials (RCT) about modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo from January 1985 to July 2013 were searched in CNKI,OVID, PubMed, CBM, EMBASE, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-analyses were conducted by using RevMan 5.1 software.

RESULTSA total of six RCTs were included. Among the 453 patients involved, 232 patients were in the modified Epley maneuver group, while the other 221 patients were in the modified Semont maneuver group. The results of meta-analyses showed that the efficacy of the modified Epley maneuve group was superior to that of the modified Semont maneuver group in one-week cure rate[OR = 3.25, 95%CI (2.08, 5.10) , P < 0.01], one-week efficient [OR = 4.72, 95%CI (1.16, 19.15) , P = 0.03], with significant differences. There was no significant difference between the two groups in three-months cure rate [OR = 2.10, 95%CI (0.57, 7.75) , P = 0.27], incidence of adverse reactions [OR = 0.82, 95%CI(0.44, 1.52), P = 0.53] and relapse rate [OR = 0.56, 95%CI (0.20, 1.57) , P = 0.27].

CONCLUSIONSBased on the current studies, modified Epley maneuver is superior to modified Semont maneuver in quicking relief posterior canal benign paroxysmal positional vertigo symptoms, but the long-term efficacy, recurrence rate and incidence of adverse reactions had no significant difference. For the quality restrictions and possible publication bias of the included studies, more double blind RCTs with high quality are required to further assess the effects.

OBJECTIVE: To evaluate the efficacy of Yacovino repositioning maneuver in patients with anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV). METHOD: Nine patients were diagnosed as ASC-BPPV from January 2013 to October 2014. All the patients were performed with Yacovino repositioning maneuver and the effective rate were evaluated by Dix-Hallpike tests. RESULT: Among the nine ASC-BPPV patients, 2 cases were successfully controlled by the first maneuver, 2 cases by the second time, and the nystagmus of 1 case was disappeared after 1 months' follow-up. The remaining 3 cases were respectively followed up till 7,8, 12 months with consistent positional downbeat nystagmus. CONCLUSION Being a relative low incidence disease, of ASC-BPPV also has low effective rate after Yacovino repositioning maneuver.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Semicircular Canals ; Vertigo

OBJECTIVE: To analyze the clinical effect of different canalith repositioning maneuver in the treatment of the apogeotropic nystagmus of horizontal semicircular canal benign paroxysmal positional vertigo (apogeotropic HSC-BPPV). METHOD: Forty patients of apogeotropic HSC-BPPV colleted from March 2014 to May 2015 were divided into two groups, each group had 20 cases. The control group was repositioned with the Gufoni maneuver before the Barbecue maneuver, the research group with the improved Nuti maneuver. RESULT: The success rate of the research group was not lower than that of the control group, which hadn't statistical (P > 0.05). And after the Barbecue maneuver, all patients have been recovered. CONCLUSION Comparing with the Gufoni maneuver, the improved Nuti maneuver designed by us, had the same success rate to treat apogeotropic HSC-BPPV, and is easier to learn,with more compliance,more comfort and more repeatability.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Nystagmus, Pathologic ; therapy ; Patient Positioning ; methods ; Semicircular Canals ; physiopathology

OBJECTIVE: To observe the effect of horizontal penetration needling at vertigo auditory area and balance area on residual dizziness after successful repositioning maneuver in patients with benign paroxysmal positional vertigo (BPPV). METHODS: Sixty-six patients with residual dizziness after successful repositioning maneuver for BPPV were randomly divided into an observation group (34 cases, 1 case dropped off) and a control group (32 cases, 2 cases dropped off). The patients in the observation group were treated with horizontal penetration needling at vertigo auditory area and balance area, once every other day; three times were taken as a course of treatment, and two courses of treatment were given. The patients in the control group received no acupuncture and medication. The dizziness handicap inventory (DHI) and visual analogue scale (VAS) scores were observed before treatment and after 1 and 2 courses of treatment. RESULTS: Except for the emotional score of DHI in the control group after 1 course of treatment, the sub item scores and total scores of DHI and VAS scores in the two groups after treatment were lower than those before treatment ( CONCLUSION Whether acupuncture or not, residual dizziness after repositioning maneuver for BPPV can be relieved within 2 weeks; horizontal penetration needling at vertigo auditory area and balance area could improve dizziness symptoms and shorten the course of disease.
Benign Paroxysmal Positional Vertigo/therapy* ; Dizziness/therapy* ; Humans ; Patient Positioning ; Vascular Surgical Procedures

OBJECTIVE: To evaluate the effect of the vestibular diagnosis and treatment system (SRM-IV ) in diagnosis and treatment of patients with benign paroxysmal positional vertigo (BPPV). METHOD: Patients who were diagnosed as BPPV by SRM-TV in the clinic of our hospital from November 2013 to October 2014 were retrospectively analyzed in this study. RESULT: Among 425 suspected cases, 230 BPPV-positive patients were diagnosed including 131 cases of posterior SC (57.0%), 95 cases of horizontal SC (41.3%) and 4 cases of more than two SC (1.7%). The cure rate by SRM-V was 94.6% and the effective rate was 100.0%. The relapsed occurred in 10 patients (4.8%), which contained 4 men and 6 women. CONCLUSION SRM-V can realize 360° reasonable repositioning procedure while Canalish reposition procedure cannot. SRM-V can improve both the corrective rate of diagnosis and the cure rate, especially for the patients who suffered from complex BPPV.
Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; Female ; Humans ; Male ; Patient Positioning ; Retrospective Studies ; Vestibule, Labyrinth ; physiopathology

OBJECTIVE: Comparative analysis of the clinical curative effect of manipulative reduction and TRV- CRP treatment of BPPV, comfort degree during reset and quality of life improvement. METHOD: One hundred and thirty-two patients with BPPV were randomly divided into two groups ,one group underwent the traditional manip- ulative reduction, the other group with TRV-CRP. DRI and VAS was evaluated in the pre and after treatment and evaluation of the efficacy was conducted. The results of two groups were compared. RESULT: The effective rate of manipulative reduction after a week treatment was 89. 23% and TRV-CRP.was 98. 51%, which was higher in TRV-CRP group than that of the manipulation reduction group(P<0. 05). The comfort degree of the manipulation reduction group was 4. 54±2. 48,higher than the TRV-CRP group which was 5. 48±1. 44 (P<0. 05). The score of DHI showed no significant difference before treatment between manipulation reduction group and TRV-CRP group(P>0. 05), the score of the two groups were decreased after a week of reduction, but the improvement of TRV-CRP group was higher than that of manipulation reduction group(P<0. 05). CONCLUSION The success rate of TRV-CRP was higher than that of manipulative reduction,but manipulative reduction comfort degree was higher than TRV-CRP, the two methods can both improve the quality of life of patients with BPPV. TRV-CRP has many advantages over manipulative reduction, but manipulative reduction is simple with low cost, and the effect is still a great advantage. In clinical work, we should reasonable combine the two methods,so as to improve the cure rate of RPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Quality of Life ; Treatment Outcome

OBJECTIVE: To compare the effectiveness of sequential treatment for subjective and objective benign paroxysmal positional vertigo(BPPV). METHOD: The efficacy of sequential treatment for nineteen vertical semicircular canal S-BPPV patients(Group A) and forty-five vertical semicircular canal O-BPPV patients(Group B) who were admitted to our hospital between January 2014 and July 2015 was retrospectively analyzed and compared, treatment of five cases with horizontal semicircular canal S-BPPV was reported here as well. RESULT: The number of repositioning maneuver for Group A was 2 - 6 times (average: 4. 21±1. 18) while 2 - 3 times (average: 2. 29 ± 0. 46) for Group B. There was significant difference between the two groups(P<0. 01). The effective rate of initial treatment for Group A was 78. 9%(15/19) while 82. 2%(37/45)for Group B. After one weeks treatment, the effective rate for Group A changed to be 89. 5% (17/19)while 88. 9% (40/45) for Group B. Non-significant difference was found in the two groups neither in the initial nor one weeks treatment. On three months' follow-up, one in Group A and two in Group B relapsed, and they were cured after treated in the initial treatment. The recurrence for Group A was 5. 3%(1/19) while 4. 4%(2/45) for Group B and there was non-significant difference. The five cases with horizontal semicircular canal S-BPPV were completely free of disease after undergoing treatment. CONCLUSION The sequential treatment is effective for both vertical semicircular canal S-BPPV and vertical semicircular canal O-BPPV, but the former needs more repositioning maneuver times. The repositioning maneuver, combined with drug therapy and head-shake-in-supine-position method is recommended for horizontal semicircular canal S-BPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Recurrence ; Retrospective Studies ; Semicircular Canals ; physiopathology ; Treatment Outcome

OBJECTIVE: To analyze the false-negative proportion and reasons of positioning test in benign paroxysmal positional vertigo (BPPV). METHOD: Sixty-eight cases were reviewed and analyzed during February to April 2009. All patients had typical clinical history of BPPV and diagnosed by positioning test,and all were treated with PRM successfully. If positioning test at the first time were negative, examinations repeated after either head shaking or return visits. RESULT: Thirteen patients (19.12%) appeared false-negative in positoning test, and 11 cases showed typical nystagmus after head shaking,while 2 cases were diagnosed by return visitis the next day. There were no statistically difference between false-negative group and positive group in age (P > 0.05), gender (P > 0.05), course of disease (P > 0.05) and types of semi-circular canal (P > 0.05). CONCLUSION Re-examinations after head shaking or return visits are useful for the diagnosis in the suspected BPPV patients who have negative positioning test.
Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; False Negative Reactions ; Humans ; Patient Positioning

OBJECTIVE: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups. METHOD: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group (< 45 years), middle-age group (45 ≤ age < 60 years) and old group (≥ 60 years). The short and long term outcomes of the three groups were observed. RESULT: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P > 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05). CONCLUSION The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.
Adult ; Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Middle Aged ; Patient Positioning ; Retrospective Studies ; Semicircular Canals ; physiopathology