Treatment of apogeotropic benign positional vertigo: Comparison of therapeutic head-shaking and modified Semont maneuver

S. Y. Oh, Ji Soo Kim, S. H. Jeong, Y. M. Oh, K. D. Choi, B. K. Kim, S. H. Lee, H. S. Lee, I. S. Moon, J. J. Lee

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Several methods of physiotherapy have been advanced for apogeotropic type benign positional vertigo involving the horizontal semicircular canal (HC-BPV). The aim of this study was to determine the therapeutic efficacies of the proposed maneuvers in apogeotropic HC-BPV. Using a prospective randomized trial involving seven nationwide dizziness clinics in Korea, we compared the immediate efficacies of head-shaking and modified Semont maneuvers in 103 consecutive patients with apogeotropic HC-BPV. We also determined an additional therapeutic benefit of mastoid oscillation while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Successful treatment was defined as resolution of positional vertigo and nystagmus, or as transition into geotropic HC-BPV. Results showed that head shaking was more effective than the modified Semont maneuver (37.3 vs. 17.3%, P = 0.02). However, therapeutic efficacy did not differ between the maneuvers after the initial non-responders switched over to the other maneuver (23.3 vs. 25.0%, P = 0.861). Mastoid oscillation provided no additional benefit while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Most positional vertigos resolved within a week (89.4%) irrespective of the treatment modalities applied and all showed resolution within 28 days. The head-shaking maneuver described here proved more effective than the modified Semont maneuver in treating apogeotropic HC-BPV. Mastoid vibration conferred no additional benefit during the Brandt-Daroff exercise.

Original languageEnglish
Pages (from-to)1330-1336
Number of pages7
JournalJournal of Neurology
Volume256
Issue number8
DOIs
StatePublished - 1 Aug 2009

Fingerprint

Vertigo
Head
Mastoid
Exercise
Physiologic Nystagmus
Therapeutics
Semicircular Canals
Dizziness
Korea
Vibration

Keywords

  • BPV involving the horizontal semicircular canal (HC-BPV)
  • Benign positional vertigo (BPV)
  • Nystagmus
  • Treatment outcome

Cite this

Oh, S. Y. ; Kim, Ji Soo ; Jeong, S. H. ; Oh, Y. M. ; Choi, K. D. ; Kim, B. K. ; Lee, S. H. ; Lee, H. S. ; Moon, I. S. ; Lee, J. J. / Treatment of apogeotropic benign positional vertigo : Comparison of therapeutic head-shaking and modified Semont maneuver. In: Journal of Neurology. 2009 ; Vol. 256, No. 8. pp. 1330-1336.
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abstract = "Several methods of physiotherapy have been advanced for apogeotropic type benign positional vertigo involving the horizontal semicircular canal (HC-BPV). The aim of this study was to determine the therapeutic efficacies of the proposed maneuvers in apogeotropic HC-BPV. Using a prospective randomized trial involving seven nationwide dizziness clinics in Korea, we compared the immediate efficacies of head-shaking and modified Semont maneuvers in 103 consecutive patients with apogeotropic HC-BPV. We also determined an additional therapeutic benefit of mastoid oscillation while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Successful treatment was defined as resolution of positional vertigo and nystagmus, or as transition into geotropic HC-BPV. Results showed that head shaking was more effective than the modified Semont maneuver (37.3 vs. 17.3{\%}, P = 0.02). However, therapeutic efficacy did not differ between the maneuvers after the initial non-responders switched over to the other maneuver (23.3 vs. 25.0{\%}, P = 0.861). Mastoid oscillation provided no additional benefit while the patients without response to both maneuvers were performing the Brandt-Daroff exercise. Most positional vertigos resolved within a week (89.4{\%}) irrespective of the treatment modalities applied and all showed resolution within 28 days. The head-shaking maneuver described here proved more effective than the modified Semont maneuver in treating apogeotropic HC-BPV. Mastoid vibration conferred no additional benefit during the Brandt-Daroff exercise.",
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Oh, SY, Kim, JS, Jeong, SH, Oh, YM, Choi, KD, Kim, BK, Lee, SH, Lee, HS, Moon, IS & Lee, JJ 2009, 'Treatment of apogeotropic benign positional vertigo: Comparison of therapeutic head-shaking and modified Semont maneuver', Journal of Neurology, vol. 256, no. 8, pp. 1330-1336. https://doi.org/10.1007/s00415-009-5122-6

Treatment of apogeotropic benign positional vertigo : Comparison of therapeutic head-shaking and modified Semont maneuver. / Oh, S. Y.; Kim, Ji Soo; Jeong, S. H.; Oh, Y. M.; Choi, K. D.; Kim, B. K.; Lee, S. H.; Lee, H. S.; Moon, I. S.; Lee, J. J.

In: Journal of Neurology, Vol. 256, No. 8, 01.08.2009, p. 1330-1336.

Research output: Contribution to journalArticle

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AU - Oh, S. Y.

AU - Kim, Ji Soo

AU - Jeong, S. H.

AU - Oh, Y. M.

AU - Choi, K. D.

AU - Kim, B. K.

AU - Lee, S. H.

AU - Lee, H. S.

AU - Moon, I. S.

AU - Lee, J. J.

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