- Radtke A, Neuhauser H, von Brevem, et al (Neurologische Klinik, Berlin)
A Modified Epley’s Procedure for Self-Treatment of Benign Paroxysmal Positional Vertigo
Neurology 53:1358-1360, 1999
Brandt-Daroff exercises (BDES), a self-treatment approach, is being replaced by canal-clearing procedures, such as Epley maneuver. The efficacy of a modified Epley procedure (MEP) that enables self-treatment was compared with that of BDES in patients with PC-B.P.P.V.
MEP is more effective in the self-treatment of PC-B.P.P.V. as it provides sufficient head rotation in the plane of posterior canal to ensure particle migration out of the canal whereas BDEs do not.
Teaching patients how to do maneuver at home is advantageous as the recurrence rate for PC-B.P.P.V. is much higher than previously believed.
- Bergenius J, Perols O (Karolinska Hosp, Stockholm; Norrtalje Hosp, Sweden)
Vestibular Neuritis : A Follow-up Study
Acta Otolaryngol (Stockh) 119:895-899, 1999
Vestibular neuritis usually involves one attack. 19 patients were followed up long term to determine, their auditory or vestibular symptoms.
At 7 to 8 years after an initial attack of vestibular neuritis, half of 19 patients had a recurrence or episodic vestibular symptoms. These symptoms were related to the vestibular tests at onset and the patient’s age. Elevated stapedius reflex threshold at onset and a slower normalisation of canal response was correlated.
Vestibular neuritis is a ablative problem of peripheral vestibular system and can be compared with Bell’s Palsy, which results into degeneration of axons followed by regeneration similarly vestibular neuritis, some mechanism causes recovery which can be demonstrated by ventribular functional recovery. However 1/3rd patients develop positional vertigo possibly because of retrograde degeneration of otoconia. It responds to treatment as well as idiopathic B.P.P.V. This is good article on long- term sequelae of vestibular neuritis.