POSTTREATMENT INSTRUCTIONS IN THE NONSURGICAL MANAGEMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO

Benign paroxysmal positional vertigo (BPPV) is the commonest periphera l vestibular disorder seen in dizziness clinics. It was long believed that the condition was caused by inorganic particles in the cupula of the posterior semicircular canal (PSC). More recently it has been sugg ested that BPPV may result from free-floating densities in the endolym ph of the long arm of the PSC. Among the various treatment modalities used, two maneuvers, each based on a different theory of pathogenesis, have reported equally high success in the control of this disorder. T hese maneuvers are customarily followed by strict post-treatment instr uctions. We studied patients with BPPV prospectively by comparing the therapeutic effectiveness of these two modalities and studying the imp ortance of post-treatment instructions in affecting the final outcome in each modality. We showed that both maneuvers were equally successfu l in controlling the symptoms and that post-treatment instructions wer e not necessary.