BMJ 1996;312:54 (6 January)

Letters

Treatment for benign positional vertigo

EDITOR,--In their review on benign positional vertigo Thomas Lempert and colleagues place great faith in the histological finding of particulate matter in the posterior semicircular canal,1 although there is a paucity of evidence that such particles are directly implicated in benign positional vertigo. Schuknecht's original observation was based on two postmortem studies.2 He then went on to describe similar findings in 149 temporal bones from 245 subjects without historical evidence of the disorder.3 Furthermore, in this study the same abnormality was found in all three semicircular canals. Most recently, particulate matter has been described in a majority of labyrinths examined, regardless of symptoms.4 The theory of canalolithiasis therefore remains plausible only in the absence of any other explanation.

It is wrong to base an entire therapeutic approach on a finding that seems to be common in asymptomatic subjects or may be an artefact. In addition, Epley's manoeuvre as described has . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Benign positional vertigo: recognition and treatment
Thomas Lempert, Michael A Gresty, and Adolfo M Bronstein
BMJ 1995 311: 489-491. [Abstract] [Full Text]

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  • Lempert, T., Gresty, M. A, Bronstein, A. M (1996). Epley's procedure should be used to treat benign positional vertigo. BMJ 312: 1300-1300 [Full text]  
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