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Inventis Maestro - July 2023

What is the role of re-positioning maneuvers in the treatment approaches for patients with BPPV?

Vishal Pawar

March 1, 2024

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Question

What is the role of re-positioning maneuvers in the treatment approaches for patients with BPPV?

Answer

Benign Paroxysmal Positional Vertigo (BPPV) is characterized by vertigo triggered by changes in head position, and it is caused by displaced crystals within the inner ear1. The primary treatment strategy involves specialized head positioning techniques known as re-positioning maneuvers2.

Re-positioning Manoeuvres

These are specific sequences of head and body movements aimed at returning displaced crystals to their appropriate location in the inner ear. This often provides immediate relief from symptoms, eliminating the need for medication in most cases3.

Over the past three years, we have successfully treated approximately 200 patients suffering from BPPV using these re-positioning maneuvers. The majority of these patients were experiencing debilitating episodes of vertigo that severely impacted their quality of life. Our clinic is equipped with a specially designed table to facilitate both the diagnosis and treatment of BPPV4.

References:

  1. Bhattacharyya N, Gubbels SP, Schwartz SR, et al. "Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update),"  Otolaryngology–Head and Neck Surgery , 2017; 156(3): 403–416. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28248609/).
  2. Hilton MP, Pinder DK. "The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo"  Cochrane Database of Systematic Reviews , 2014; (12): CD003162. [PubMed](https://pubmed.ncbi.nlm.nih.gov/25526741/).
  3. Fife TD, Iverson DJ, Lempert T, et al. "Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review)"  Neurology , 2008; 70(22): 2067–2074. [PubMed](https://pubmed.ncbi.nlm.nih.gov/18505980/).
  4. Von Brevern M, Radtke A, Lezius F, et al. "Epidemiology of benign paroxysmal positional vertigo: a population based study"  Journal of Neurology, Neurosurgery, and Psychiatry , 2007; 78(7): 710–715. [PubMed](https://pubmed.ncbi.nlm.nih.gov/17158831/).

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vishal pawar

Vishal Pawar

Dr. Vishal Pawar is a highly skilled specialist neurologist with over a decade of experience in neurology and oto-neurology. He completed his MBBS, DNB in Medicine, and DNB in Neurology in India and has been a valuable member of the Aster Gardens specialty clinic in Dubai for seven years. Dr. Pawar's expertise lies in vestibular medicine and headache disorders, and he has actively contributed to patient care, academics, and research in these areas. He has earned recognition as a Fellow of the European Board of Neurology and has established a dedicated vertigo clinic.


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