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Home Exercises Defeat Dizziness

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TUESDAY, July 13 (HealthDayNews) -- People with a type of vertigo that strikes when they roll over in bed or bend their heads back to look up can probably beat those dizzy spells by doing some simple exercises.

One prescribed set of head and body movements works particularly well, German researchers report in the July 13 issue of Neurology. After one week, 95 percent of patients who performed the maneuvers no longer had symptoms, the study found.

For people who fail to respond to a single treatment in the doctor's office or who experience recurring bouts of dizziness, self-treatment offers new hope.

"Many of these patients have had vertigo for many weeks and even months, so for them it is a true relief to get rid of their vertigo," said study author Dr. Andrea Radtke, a neurologist with Charité Campus Virchow Clinic in Berlin.

It also gives patients a sense that they can control symptoms on their own. "In this respect, it is a great advantage for patient self-management," Radtke said.

An accompanying editorial says that self-treatment is likely to become part of the routine management for this condition.

Dr. Timothy C. Hain, a co-author of the editorial and professor of physical therapy, neurology, and otolaryngology at Northwestern University, said the findings represent a significant advance in the management of this very common type of vertigo.

"It is likely that at-home treatment will be combined with the office treatment to greatly increase the speed of cure," he said. "Patients will be diagnosed in the office, shown the treatment, and sent home to treat themselves."

The study focuses on people with benign paroxysmal positional vertigo (BPPV), who experience a spinning sensation, lightheadedness, imbalance or nausea with sudden head movements. Symptoms tend to come and go. About 65 people in every 100,000 have the condition.

This type of vertigo occurs when crystals of calcium carbonate, sometimes called ear rocks, float free within the inner ear canal, disrupting the body's normal sense of balance.

It's not always known why these crystals break loose. In older people, the most common cause is degeneration of the vestibular system -- the network of fluid-filled tubes and chambers within the inner ear that helps control balance, says the American Hearing Research Foundation.

The study compared two types of self-treatment, which are modified versions of established treatments that physicians and physiotherapists use to resolve positional vertigo. Both involve head and body movements that are done at home while sitting in bed.

Seventy patients, ranging in age from 35 to 80, participated in the study. All had suffered with acute positional vertigo for a median of eight weeks.

Half of the patients performed one movement, called a modified Epley procedure; the other half did something called a modified Semont maneuver. Patients performed the maneuver once under a physician's supervision and then were instructed to do the exercise three times a day until their vertigo had stopped for at least 24 hours.

The basic difference is that Epley entails a series of head movements while Semont involves a single, swift movement. In each case, the purpose is to reposition the particles in the ear canal to restore equilibrium.

After a week, almost all of the patients who performed the modified Epley procedure said their symptoms vanished. Fifty-eight percent of people who did the modified Semont maneuver no longer had symptoms.

The authors did not use a control group, saying it would be unethical not to treat positional vertigo sufferers in light of previously published research suggesting that the Epley procedure and Semont maneuver are equally effective and have high response rates after one or two applications.

More information

The American Hearing Research Foundation has more about benign paroxysmal positional vertigo.

SOURCES: Andrea Radtke, M.D., neurologist, Charité Campus Virchow Clinic, Berlin, Germany; Timothy C. Hain, M.D., professor, physical therapy and human movement science, neurology and otolaryngology, Northwestern University, Evanston, Ill.; July 13, 2004, Neurology
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