Treatment outcomes of benign paroxysmal positional vertigo

Objective: The purpose of this study was to examine the efficacy of the par ticle repositioning manoeuvre (PRM) in the treatment of benign paroxysmal p ositional vertigo (BPPV). Design: A randomized prospective study of patients with BPPV. Methods: Seventy-one patients were randomized to one of three groups at the ir first clinic visit. These groups included the PRM, a sham PM and a contr ol group. Patients were followed up in clinic at 2 weeks and 3 months. The mean long-term follow-up was 12 months. A telephone questionnaire was also conducted. Results: At 2-week follow-up, 81.8% of patients in the PRM group had a reso lution of symptoms and a negative Dix-Hallpike test compared with 15.3% in the sham PRIM group and 60% in the control group. This difference was stati stically significant between the treatment (PRM) and sham PRM groups and be tween the sham and control groups. It nearly reached significance between t he treatment and control groups (p = 0.06). The sham treatment group had by far the worst outcome at the 2-week interval. There was no statistically s ignificant difference between the groups after 2 weeks. Conclusion: The PRM is side specific. It may help induce remission of the v ertiginous symptoms of BPPV in the short term. This cannot be attributable to a placebo effect. The PRM does not seem to affect the natural history of the disorder in the long term. The sham treatment causes a delay in sponta neous recovery, possibly by preventing the particles from falling into the utricle. This study has not compared the frequency or severity of symptoms.