Paroxysmal positional vertigo: an overview and the deposits repositioning maneuver

In a retrospective live study, electronystagmographic (ENG) recordings in patients (n = 526) suffering from paroxysmal positional vertigo (PPV) of the posterior semicircular canal were divided into group I (n = 425) and group II (n = 101), depending on whether the vertigo could or could not be elicited at the time of recording. There was no statistical difference between the two groups for (1) the ipsilateral (fast phase toward the affected side) or the contralateral positional nystagmus (excluding the nystagmus recorded during the paroxysm) or (2) the bithermal caloric labyrinthine or directional preponderance; nor within each group for (1) the ipsilateral versus the contralateral positional nystagmus or (2) the ipsilateral (on the affected side) versus the contralateral labyrinthine and/or directional preponderance. In a prospective study, the deposits repositioning maneuver (DRM) was attempted in 41 patients. One day post-treatment patients felt no change, better, or free of vertigo. Most patients, who developed nystagmus in the final DRM head position similar to the nystagmus observed in the provocative head position had a better outcome. It is concluded that ENG recordings do not contribute to the diagnosis of PPV. The type of observed nystagmus in the final DRM head position is frequently an outcome predictor. Following the DRM, failures and/or recurrences are to be expected.