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ABSTRACT
Objective: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid change in head position, associated with a characteristic paroxysmal positional nystagmus. Posterior canal benign paroxysmal positional vertigo is the most frequent form of BPPV. The aim of our study was to investigate and compare the effectiveness of Epley maneuver and Brand-Daroff home exercises for the treatment of posterior canal BPPV.
Methods: A total of 50 patients between 27 and 76 years of age who were diagnosed with unilateral posterior canal into BPPV were randomized prospectively into two groups. In Group-1, modified particle repositioning maneuver and in Group-2 Brandt-Daroff exercises were utilized as treatment. Patients were followed weekly. Cure weeks were recorded. The patients were followed for 12 to 24 months for recurrence.
Results: The recovery rates at the first, second and third week controls were 76%, 96% and 100% for Group-1 (modified Epley maneuver) and 64%, 88% and 100% for Group-2 (Brandt-Daroff exercises) respectively. The recovery rates were similar for both groups. The average follow-up duration was 18 months. In Group 1, 7 patients (28%) and in Group 2, 5 patients (20%) had recurrence, which was also similar with no statistical difference.
Conclusion: It was concluded that both Brandt-Daroff Exercises and Modified Epley maneuvers were almost equally effective in the treatment of BPPV.
KEYWORDS: Benign positional paroxysmal vertigo, Brandt-Daroff exercises, Canalith repositioning maneuvers, Video electronystagmography.
doi: https://doi.org/10.12669/pjms.343.14786
INTRODUCTION
Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, with an incidence of 64/100,000. BPPV was first described by Barany in 1921, and a diagnostic maneuver was implemented in 1952 by Dix and Hallpike.1-3
The most common type of BPPV is posterior semicircular canal BPPV, with a rate of approximately 85%. Determination of the affected canal in BPPV is important for treatment. The most widely used tests for the diagnosis of BPPV and identifying the affected canal are the Dix-Hallpike test and Roll test. Several maneuvers based on cupulolithiasis and canalolithiasis theories have been proposed for BPPV treatment by Brandt, Daroff, Norre, Beckers, and McCabe.4-6 Presently, the most widely used maneuver for the treatment of posterior canal BPPV is the canalith repositioning procedure of Epley.7 In resistant cases...