Benign paroxysmal positional vertigo (BPPV) is the most common 'provoked vertigo'. In Japan, there has not been any physiotherapy attempted for this clinical entity and this is the first report implementing the method described by Epley. Two techniques were used in this small preliminary series. One was the conventional Epley's maneuver using a vibrator and the other involved the same head positions without a vibrator but tapping the mastoid bone with fingers or fist. Fifteen BPPV patients with classic nystagmus were selected and underwent therapy by one of the two methods. In thirteen of the fifteen patients, no further positioning vertigo occurred after a single session. But two patients said that they felt light dizziness due to other unknown causes, which were not associated with changing the head position. One was completely cured after three sessions. In one patient, BPPV partially remained. As the patient had concomitant heart disease, she could not undergo another session. None of the patients were unchanged or worse after the treatment. Epley's maneuver either with or without a vibrator showed excellent results. We recommend that this be the first choice of treatment for persistent BPPV.
