Is web-guided diagnosis and treatment feasible and effective in recurrent benign paroxysmal positional vertigo?

Web-guided diagnosis and treatment of recurrent benign paroxysmal positional vertigo (BPPV) proved efficacious in a randomised parallel-group study in South Korea.

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo with frequent recurrences. Dizziness/vertigo is the third most common symptom prompting emergency department visits, accounting for 3.5% to 11% of total emergency department visits, with an annual cost estimated at $3.9 million in the US in 2011. BPPV is believed to be caused by dislodged otoconia that enter the semicircular canals. In response to a change in the static orientation of the head with respect to gravity, the otolithic debris moves to a new position within the semicircular canals, leading to a false sense of rotation.

The canalith repositioning maneuver (CRM) can effectively treat BPPV. CRM results in immediate resolution of BPPV in about 80% of patients after a single application, and the success rate increases to 92% with repetition. By virtue of its relative ease, patients may attempt the CRM, but accurately identifying the affected canal is essential since the CRM is canal specific.

Kim et al conducted a multicenter, randomized, parallel-group, double-blind trial to assess the efficacy of diagnosis and treatment of BPPV using a web-based system at 4 medical centers in South Korea.