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Efficacy of Treatments for Posterior Canal Benign Paroxysmal Positional Vertigo


  • Helen S. Cohen EdD,

    Corresponding author
    1. Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas
    • Helen Cohen, EdD, Department of Otorhinolaryngology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, U.S.A.
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  • Jaroslav Jerabek MD

    1. Neurologic Clinic, Charles University, Prague, Czech Republic.
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  • Presented in part at the 19th Meeting of the Barany Society, Sydney, Australia, August 12, 1996.

  • Supported by the Clayton Foundation for Research and NIH grant DC02412 (H.S.C.) and by Czech Grant Agency grant 309/95/0326 (J.J.).


Objective: This study was performed to determine the relative effectiveness of several passive head maneuvers for treating benign paroxysmal positional 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 maneuver with augmented head rotations, and modified Semont maneuver. They were interviewed 1 week after receiving one maneuver. If subjects desired further treatment, they were treated again with the same maneuver, a methodology repeated until subjects desired no further treatment; they were telephoned 3 and 6 months after the last treatment.

Results: The groups did not differ significantly, 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 induced vertigo; common comorbid conditions were osteoporosis, cervical spine problems, and head trauma.

Conclusions: These data suggest that augmented head rotations are unnecessary and that the modified Epley and Semont maneuvers are equally effective in the remediation of vertigo in this population.