Abstract
We devised an original non-specific positional therapeutic strategy for benign paroxysmal positional vertigo (BPPV), and we achieved better results than before, however, there were intractable cases. The background factor of such cases was examined in this study. The study subjects comprised is 54 patients in whom it took three months or more before giddiness disappeared from among 666 cases who were diagnosed in our department as having BPPV. The background factors examined were the existence of the period to consultation, age, sex, past history, car sickness and lack of an exercise habit. It was revealed that history of any blow to the head, blow, whiplash injury, car sickness, lack of an exercise habit and the time to consultation were significantly different between intractable cases and treatable cases. Our results suggested that cases of BPPV associated with blows to the head were prone to be intractable to non-specific therapy. The characteristics of patients who easily become intractable cases were as follows. BPPV easily occurred with a history of any blow to the head, the reason for which we believed was that such cases would quite probably not undergo a medical examination at a hospital because their BPPV-related symptoms were relatively short. Therefore, it was possible that they might not consult any hospital doctor for a long time from the disease onset and the recovery of their symptoms was prone to be delayed. In addition, they may have recognized that positional therapy was important to cure their symptoms, however they felt severely nauseous because of vertigo during therapy. As a result, they became prone not to remaining still because of positional vertigo and their symptoms would probably become intractable. It is necessary to give early and appropriate treatment to avoid intractability of their symptoms. We additionally noted that repeated explanations regarding the treatment of the disease were also important to ensure good compliance with their BPPV treatment.
