Efficacy of treatments for posterior canal benign paroxysmal positional vertigo

Objective: This study was performed to determine the relative effectiveness of several passive head maneuvers for treating benign paroxysmal positiona l vertigo. Study Design: This prospective study used 87 subjects diagnosed by their physicians with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal. Methods: Subjects were randomly assigned to three treatment groups: modified Epley maneuver, modified Epley maneuve r with augmented head rotations, and modified Semont maneuver. They were in terviewed 1 week after receiving one maneuver. If subjects desired further treatment, they were treated again with the same maneuver, a methodology re peated until subjects desired no further treatment; they were telephoned 3 and 8 months after the last treatment, Results The groups did not differ si gnificantly, but subjects decreased significantly on vertigo intensity and frequency and improved significantly on independence in activities of daily living. Before treatment, tasks requiring pitch rotations of the head indu ced vertigo; common comorbid conditions were osteoporosis, cervical spine p roblems, and head trauma. Conclusions: These data suggest that augmented he ad relations are unnecessary and that the modified Epley and Semont maneuve rs are equally effective in the remediation of vertigo in this population.