Many researchers have reported the usefullness of repositioning manuevers for BPPV, such as Epley's procedure and Lempert's method, since canalolithiasis was recently found to be an etiologic factor of BPPV. The affected side should be determined before performing repositioning manuevers, because the therapy is directed to the posterior or horizontal semicircular canal on the affected side. However, in many cases the affected side cannot be determined because symptoms and signs are not found at the time of their visit. On this study, we investigated data taken at first visit from patient with suspected BPPV to determine the affected side. We also investigated the ther-apeutic effects of habituation training therapy which we used for BPPV.
BPPV was suspected in 203 of 737 outpatients complaining of vertigo on their first visit. A previous history of positioning vertigo was reported in 199 of the 203 patients with suspected BPPV. However, a difference in vertigo between right-ear-down and left-ear-down position was clear only in 47 patients (23.2%), and it was not clear in 156 (76.8%). Decreasing and alternative positional nystagmus was observed in 92 patients (45.3%), and not observed in 111 (54.7%). Thus, the affected side was determined in only 95 patients (46.8%), and not determined in 108 (53.2%). Habituation training therapy was performed in 190 patients with BPPV and suspected BPPV. As a result, positional vertigo and/or nystagmus disappeared after therapy in 183 patients. The habituation training therapy was found to be effective to treat BPPV not only when the affected side was determined, but also suspected BPPV when the affected side was undetermined.
