Question
What role does canalith repositioning treatment (CRT) play in the treatment of vertigo? What signs on ENG would indicate the need for CRT?
Answer
CRT (aka: the Semont Liberatory maneuver and/or the Epley maneuver) is a treatment used for the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV). Therefore, CRT is not ''a general treatment for vertigo.'' Rather, it is a treatment option for vertigo secondary to BPPV. CRT has had overwhelming success (successful approximately 85 to 90 percent of the time) in treating BPPV. The signs on the ENG that would need to be present to indicate the need for CRT, are essentially the ''positive Hallpike Maneuver signs'' for BPPV.
BPPV NOTES (signs and symptoms)
BPPV was described by Barany in 1921, further describe by Dix-Hallpike in 1952. BPPV has vertigo that has a latency of 10 to 30 seconds, is paroxysmal, includes rotary nystgamus, lasts less than 1 minute, following placement of the head in the provoking position. BPPV fatigues with repetition, Dix-Hallpike maneuver duplicates patient's symptoms, nystagmus may reverse when patient is upright, BPPV vertigo is ''positioning'' provoked (Hall and Mueller, 1997).
REFERENCE:
Hall and Mueller, Audiology Desk Reference, Singular Publishing, San Diego, 1997.
Dr. Trahan is a graduate of LSUHSC, Masters of Communicative Disorders. Graduate of the University of Florida, Doctor of Audiology
Currently:
Assistant Professor of Audiology at the Arizona School of Health Sciences. Lead faculty for the 4 year AuD Residential program. Currently also teaching Vestibular Assessment Procedures and Balance Remediation in the ASHS AuD Distance Ed AuD program.
Past:
20 years private practice with significant involvement in assessment of vestibular disorders and vestibular rehabilitation.
Conducted numerous workshops and presentations in regards to Audiologists in private practice adding Vestibular Assessment and Vestibular Rehabilitation to their practices.