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Original ArticleOpen Access
Treatment of Benign Paroxysmal Positional Vertigo by Canalith Repositioning Procedure : Experience from Srinagarind Hospital
Yimtae K 
,
Srirompotong S ,
Kraitrakul S
,
Srirompotong S ,
Kraitrakul S KWANCHANOK YIMTAE, M.D.*,
SOMCHAI SRIROMPOTONG, M.D.*,
SUTHEE KRAITRAKUL, M.D.*
Introduction
: Benign paroxysmal positional vertigo (BPPV) is one of the most common
causes of vertigo. The diagnosis is confirmed by observing a classical response during the Dix-
Hallpike maneuver. The cause of BPPV is usually idiopathic. There are two popular hypotheses
described regarding the pathogenesis of BPPV. The first one is the "cupulolithiasis" hypothesis,
and the second hypothesis, the so-called "canalithiasis" hypothesis. The clinical course of BPPV
is spontaneous recovery in weeks or months. Treatments for BPPV have ranged from no inter-
vention to surgical treatment. The new treatment, "Canalith-repositioning procedure (CRP)"
which was introduced by Epley in 1992 produces a very high rate of success. This treatment has
caused interest and has been modified and studied worldwide in recent years.
Objective
: To study the efficacy of the canalith-repositioning procedure that we modified
from Epley's maneuver in the treatment of BPPV patients.
Design
: A descriptive study. The BPPV patients, who came to the neurotologic clinic at
Srinagarind Hospital from January 1997 to December 1998, were treated with our technique
that was modified from Epley's maneuver. We neither used pre-medication, a mastoid oscillator,
nor post-treatment instruction.
Results
: The total number of patients included in this study was 19. The efficacy of
this procedure for curing nystagmus and vertigo was 89.5 per cent. One patient did not follow-up
and one patient did not respond to the CRP. Complication such as vago-vagal reflex, lateral
canalithiasis, occurred in 5.3 per cent of the patients. The recurrence of BPPV in our study was
26.3 per cent. However, CRP was also effective in treatment of both patients with recurrence
as well as those without recurrence.
Conclusion
: The canalith-repositioning procedure that is modified from Epley is
effective in the treatment of BPPV.
Key word
: Benign Paroxysmal Positional Vertigo, Treatment, Canalith Repositioning Procedure
SOMCHAI SRIROMPOTONG, M.D.*,
SUTHEE KRAITRAKUL, M.D.*
Introduction
: Benign paroxysmal positional vertigo (BPPV) is one of the most common
causes of vertigo. The diagnosis is confirmed by observing a classical response during the Dix-
Hallpike maneuver. The cause of BPPV is usually idiopathic. There are two popular hypotheses
described regarding the pathogenesis of BPPV. The first one is the "cupulolithiasis" hypothesis,
and the second hypothesis, the so-called "canalithiasis" hypothesis. The clinical course of BPPV
is spontaneous recovery in weeks or months. Treatments for BPPV have ranged from no inter-
vention to surgical treatment. The new treatment, "Canalith-repositioning procedure (CRP)"
which was introduced by Epley in 1992 produces a very high rate of success. This treatment has
caused interest and has been modified and studied worldwide in recent years.
Objective
: To study the efficacy of the canalith-repositioning procedure that we modified
from Epley's maneuver in the treatment of BPPV patients.
Design
: A descriptive study. The BPPV patients, who came to the neurotologic clinic at
Srinagarind Hospital from January 1997 to December 1998, were treated with our technique
that was modified from Epley's maneuver. We neither used pre-medication, a mastoid oscillator,
nor post-treatment instruction.
Results
: The total number of patients included in this study was 19. The efficacy of
this procedure for curing nystagmus and vertigo was 89.5 per cent. One patient did not follow-up
and one patient did not respond to the CRP. Complication such as vago-vagal reflex, lateral
canalithiasis, occurred in 5.3 per cent of the patients. The recurrence of BPPV in our study was
26.3 per cent. However, CRP was also effective in treatment of both patients with recurrence
as well as those without recurrence.
Conclusion
: The canalith-repositioning procedure that is modified from Epley is
effective in the treatment of BPPV.
Key word
: Benign Paroxysmal Positional Vertigo, Treatment, Canalith Repositioning Procedure
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