Strategies to prevent recurrence of benign paroxysmal positional vertigo

To determine if a daily routine of Brandt-Daroff exercises increases the time to recurrence and reduces the rate of recurrence of benign paroxysmal positional vertigo (BPPV).

Random sample of convenience and retrospective case review.

Tertiary referral center and outpatient clinic.

One hundred sixteen patients diagnosed with BPPV involving the posterior semicircular canal (BPPV-PC) who were successfully treated with the canalith repositioning procedure.

Patients in the treatment group (n = 43) performed daily Brandt-Daroff exercises, while patients in the no-treatment group (n = 73) performed no exercises.

Follow-up was as long as 2 years. Every 2 months patients were mailed a questionnaire. If BPPV had recurred, patients contacted the principal investigator within 24 hours. Within 1 to 2 weeks, patients were evaluated in the clinic with the Dix-Hallpike maneuver or, if unable to travel to the clinic, interviewed by telephone.

Symptoms recurred in 50 (43%) of the 116 subjects, 34 (47%) of 73 in the no-treatment group and 16 (37%) of 43 in the treatment group. There was no significant difference in the frequency of recurrence (Pearson chi(2), P = .33) or time to recurrence (survival analysis, log-rank test, P = .92). A history of recurrent BPPV-PC did not affect frequency of recurrence (Pearson chi(2), P = .33) or time to recurrence (survival analysis, log-rank test, P = .72).

Our results suggest that a daily routine of Brandt-Daroff exercises does not significantly affect the time to recurrence or the rate of recurrence of BPPV-PC.