Semont's liberatory maneuver for treatment of benign paroxysmal positional vertigo (BPPV)

Abstract

We retrospectively determined the efficacy of Semont's liberatory maneuver in 52 patients with benign paroxysmal positional vertigo (BPPV). Vertigo and torsional nystagmus, characteristic of BPPV, had been induced by the Hallpike maneuver at the time of diagnosis. Thirty of these patients were treated by Semont's maneuver after being informed in detail about the method. If vertigo reoccurred after treatment, they repeated the maneuver at home twice a day (after awaking and before going to bed) until vertigo disappeared. Patients received no medication and were followed until complete remission or for up to 1 year. The other 22 patients received either no treatment or were treated with medication only; they were followed for up to 9 years. Disappearance of nystagmus was ascertained for the first group only at our dizziness clinic. While most of these patients exhibited nystagmus lasting < 30 seconds (indicating the mechanism of canalolithiasis), two had nystagmus lasting> 1 minute, a sign of cupulolithiasis-induced BPPV. Complete remission of BPPV occurred in 28 patients in the first group or 93.3%; 19 (68%) of these patients showed remission within 3 days. In the second group, the vertigo was resolved in only 9 of the 22 patients (40.9%). The difference in the remission rate of the two groups was significant (p < 0.0001). Our results proved the efficacy of Semont's maneuver for treating not only the more common type of BPPV caused by canalolithiasis but also the less common type induced by cupulolithiasis.