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Updated: May 20, 2026
05:02
Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction
Published on: August 30, 2019
Clinical features of recurrent or persistent benign paroxysmal positional vertigo
Seong Jun Choi1, Jong Bin Lee, Hye Jin Lim
1Department of Otorhinolaryngology, Konyang University, Daejeon, Republic of Korea.
Summary
Recurrent and persistent benign paroxysmal positional vertigo (BPPV) are common, particularly with secondary causes. Frequently repeated canalith repositioning procedures (CRPs) effectively treat these challenging BPPV cases.
Area of Science:
- Neurology
- Otolaryngology
- Vestibular Disorders
Background:
- Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
- Recurrent or persistent forms of BPPV present unique diagnostic and therapeutic challenges.
- Understanding the clinical features and causes of persistent and recurrent BPPV is crucial for effective management.
Purpose of the Study:
- To identify the clinical features and underlying causes of recurrent or persistent BPPV.
- To evaluate the efficacy of frequently repeated canalith repositioning procedures (CRPs) in managing these BPPV subtypes.
Main Methods:
- Retrospective chart review of 120 BPPV patients diagnosed between 2004 and 2008.
- Defined persistent BPPV as lasting >2 weeks and recurrent BPPV as recurrence after a symptom-free interval.
- Treated patients with repeated CRPs (modified Epley or barbecue rotation) every 2-3 days.
Main Results:
- Of 120 patients, 77.5% were typical, 12.5% persistent, and 10% recurrent BPPV.
- Idiopathic causes were most common, but secondary causes (e.g., trauma) were more frequent in persistent/recurrent BPPV.
- Posterior canals were most affected in typical/recurrent BPPV; lateral canals in persistent BPPV.
- Frequently repeated CRPs achieved resolution of nystagmus and vertigo in 91.7% of recurrent and 86.7% of persistent BPPV cases.
Conclusions:
- Recurrent and persistent BPPV occur more frequently than previously thought, especially in patients with secondary causes.
- These challenging BPPV presentations can be successfully managed with a therapeutic approach involving frequently repeated CRPs.
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