J Korean Soc Emerg Med.  2010 Oct;21(5):588-593.

The Effect of Early Repositioning Therapy in Patients with Benign Paroxysmal Positional Vertigo

• Oh CK
• Lee YJ
• Ki W
• Kim J

Abstract

PURPOSE
Benign paroxysmal positional vertigo (BPPV), the most common cause of vertigo, can be treated with a simple repositioning maneuver. But there are few reports about the underlying mechanism of this problem or about prognostic factors for recurrent BPPV, which is frequently encountered after symptoms have subsided. Among reported prognostic factors in BPPV, repositioning timing in the treatment of BPPV has been considered by some physicians to be an important one, especially for recurrence. Our study was done to demonstrate, in patients with BPPV, the effect of early repositioning therapy on disease recurrence.
METHODS
We enrolled consecutive 73 patients who had been diagnosed BPPV in the department of emergency and otolaryngology in Seoul Samyook hospital between January 2009 and June 2009. All patients who were diagnosed with BPPV immediately had appropriate canalith repositioning maneuvers (CRM) done (depending on the type of BPPV) by emergency department or otolaryngology department doctors. Patients were classified according to the timing of treatment after onset (within 24 hours, after 24 hours). We prospectively compared recurrence rates between the two groups.
RESULTS
Of the 73 patients, recurrence was seen in 16 (22.2%): 4(11%) of 36 patients in the early treatment group (within 24 hours), and 12(31.4%) of 37 patients in the delayed group (after 24 hours). The between group difference in recurrence rates was significant (p<0.05, chi-square test; p=0.053, logistic regression). The incidence of recurrence of BPPV was much higher in older patients (p<0.05, t-test. logistic regression>0.1).
CONCLUSION
Recurrence of BPPV is affected by early CRM after symptom onset. Doing CRM as soon as possible after symptom onset is important

Keyword

Benign paroxysmal positional vertigo; Canalith repositioning maneuvers; Recurrence

MeSH Terms

Emergencies
Humans
Incidence
Otolaryngology
Prospective Studies
Recurrence
Vertigo
Vertigo