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Management of bilateral benign paroxysmal positional vertigo.

Kaplan DM, Nash M, Niv A, Kraus M

Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel. dankap@bgumail.bgu.ac.il

OBJECTIVE: To describe a series of patients with bilateral benign paroxysmal positional vertigo (BiBPPV), with respect to demographics, management, and outcome. METHODS: All patients who were identified and treated for BiBPPV in a previous 36-month period with a minimal follow-up period of 6 months were included. Patients were treated with Epley's maneuver (EM) on the side that was more symptomatic and that had a greater velocity and amplitude of tortional nystagmus. Patients were re-treated according to symptoms and findings on follow-up visits. RESULTS: Ten patients were identified with BiBPPV. Most patients complained of nonlocalized positional vertigo and unsteadiness. Four were males and 6 were females, and the mean age was 54 years. There was a positive history of recent head trauma in 4 of the patients. All patients recovered after performing a mean of 2.6 EMs during a 3-month period. One patient experienced unilateral recurrence and was re-treated successfully. CONCLUSION: BiBPPV has typical characteristics and can be managed successfully with EM, performed on the more symptomatic side, followed by repeated treatments as needed. EBM RATING: C.

Published 8 November 2005 in Otolaryngol Head Neck Surg, 133(5): 769-73.
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