Strategies to prevent recurrence of benign paroxysmal positional vertigo

OBJECTIVE: To determine if a daily routine of Brandt-Daroff exercises increases the time to recurrence and reduces the rate of recurrence of benign paroxysmal positional vertigo (BPPV). DESIGN: Random sample of convenience and retrospective case review. SETTING: Tertiary referral center and outpatient clinic. PATIENTS: One hundred sixteen patients diagnosed with BPPV involving the posterior semicircular canal (BPPV-PC) who were successfully treated with the canalith repositioning procedure. INTERVENTIONS: Patients in the treatment group (n = 43) performed daily Brandt-Daroff exercises, while patients in the no-treatment group (n = 73) performed no exercises. MAIN OUTCOME MEASURES: Follow-up was as long as 2 years. Every 2 months patients were mailed a questionnaire. If BPPV had recurred, patients contacted the principal investigator within 24 hours. Within 1 to 2 weeks, patients were evaluated in the clinic with the Dix-Hallpike maneuver or, if unable to travel to the clinic, interviewed by telephone. RESULTS: Symptoms recurred in 50 (43%) of the 116 subjects, 34 (47%) of 73 in the no-treatment group and 16 (37%) of 43 in the treatment group. There was no significant difference in the frequency of recurrence (Pearson chi(2), P = .33) or time to recurrence (survival analysis, log-rank test, P = .92). A history of recurrent BPPV-PC did not affect frequency of recurrence (Pearson chi(2), P = .33) or time to recurrence (survival analysis, log-rank test, P = .72). CONCLUSION: Our results suggest that a daily routine of Brandt-Daroff exercises does not significantly affect the time to recurrence or the rate of recurrence of BPPV-PC.