Persistent benign paroxysmal positional vertigo: our experience and proposal for an alternative treatment

Area of Science:

• Neurology
• Otolaryngology
• Vestibular Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.
• Canalith repositioning procedures (CRPs) are effective, but BPPV can persist (PBPPV).
• Alternative treatments are sought to avoid invasive or drug therapies for PBPPV.

Purpose of the Study:

• To evaluate the efficacy of prolonged, self-assessed temporal bone vibration (TBV) in treating persistent BPPV (PBPPV).
• To compare TBV outcomes with those of the general BPPV population treated with CRPs.
• To assess the recurrence rate of BPPV (RBPPV) after TBV treatment.

Main Methods:

• Seventy-two PBPPV patients (51 posterior semicircular canal [PSC], 21 lateral semicircular canal [LSC]) underwent twice-daily self-assessed TBV using a massaging cushion.
• Patients were re-tested after 1 week, and considered disease-free if positioning tests remained negative for 1 month.
• BPPV and PBPPV groups were monitored for recurrence over 12-24 months.

Main Results:

• Significant positive outcomes (P < 0.01) were observed in 70.6% of PSC PBPPV and 61.9% of LSC PBPPV patients.
• Outcomes were not biased by age or gender.
• No statistically significant differences in recurrence rates were found between CRP and TBV treated groups in multiple regression analysis.

Conclusions:

• Self-assessed, prolonged TBV is a potential alternative treatment for PBPPV.
• TBV offers a non-invasive option, potentially avoiding more invasive procedures and side-effect-prone medications.
• TBV may be a viable therapeutic strategy for managing persistent BPPV.