Recurrence of symptoms following treatment of posterior semicircular canalbenign positional paroxysmal vertigo with a particle repositioning manoeuvre

A consecutive series of 51 patients (34 females and 17 males) with posterio r semicircular canal benign positional paroxysmal vertigo (BPPV) were treat ed with the modified Epley particle positioning manoeuvre (PRM). Follow-up data were available on all 51 patients. After one manoeuvre, 42 patients ha d a negative Dix-Hallpike test, and after a second manoeuvre, 8 of the rema ining 9 patients had a negative Dix-Hallpike rest (testing was conducted 1 to 2 weeks after the PRM was performed). Therefore, the overall short-term success rate after two manoeuvres was 50 of 51 patients (98%), which is sim ilar to other series. A follow-up questionnaire to determine the incidence of recurrence of symptoms was administered after a minimum period of 30 wee ks. Twenty-three patients reported a recurrence (or, in the case of the one treatment failure, persistence) of their symptoms (45%). Therefore, althou gh virtually all patients can be created successfully with the PRM, almost half of these patients can be expected to experience a further recurrence o f symptoms. This long-term recurrence rate is higher than has previously be en reported and is a significant factor clinicians must be aware of in thei r treatment of this condition. In particular, this finding emphasizes the n eed for patient counselling with regard to the likelihood of recurrence and access to follow-up treatment ii recurrence occurs.