The effect of the canalith repositioning maneuver on resolving postural instability in patients with benign paroxysmal positional vertigo

Objective: Patients with benign paroxysmal positional vertigo (BPPV) often experience postural instability as well as brief episodes of vertigo. The p urpose of this study was to determine whether successful resolution of the episodic vertigo, through use of the canalith repositioning treatment, woul d be accompanied by improvement in postural stability. Study Design: Prospective clinical study. Setting: Outpatient tertiary care facility in a university. Patients: Thirty-three patients with a diagnosis of the canalithiasis form of BPPV affecting the posterior canal unilaterally. All patients had comple te remission of the positional vertigo after treatment. Patients with abnor mal caloric or rotary chair test results were excluded from the study. Intervention: The posterior canal BPPV was treated by the canalith repositi oning treatment. Main Outcome Measures: Postural stability was assessed by computerized dyna mic posturography before and 1 to 2 weeks after treatment. Six different su btests were used. Results: A significant number of patients had abnormal stability, as measur ed with computerized dynamic posturography, before treatment. After treatme nt there was a significant increase in the number of subjects with normal r esults on the different subtests; however, not all patients had normal post ural stability. Younger subjects were more likely to show improved stabilit y. Conclusions: Treatment of BPPV using the canalith repositioning treatment r esults in improved postural stability in patients with BPPV. Not all patien ts have normal stability after treatment, however, and assessment and treat ment of the balance problems may be necessary.