Treatment of benign positional vertigo in the elderly: a randomized trial.
Identifieur interne : 000352 ( Main/Exploration ); précédent : 000351; suivant : 000353Treatment of benign positional vertigo in the elderly: a randomized trial.
Auteurs : Fabrizio Salvinelli [Italie] ; Maurizio Trivelli ; Manuele Casale ; Luca Firrisi ; Valerio Di Peco ; Luca D'Ascanio ; Fabio Greco ; Angela Miele ; Tommaso Petitti ; Roberto BernabeiSource :
- The Laryngoscope [ 0023-852X ] ; 2004.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Association thérapeutique (MeSH), Flunarizine (usage thérapeutique), Humains (MeSH), Inhibiteurs des canaux calciques (usage thérapeutique), Posture (MeSH), Qualité de vie (MeSH), Sujet âgé (MeSH), Vertige (thérapie), Vertige (traitement médicamenteux), Études de suivi (MeSH), Études prospectives (MeSH).
- MESH :
- thérapie : Vertige.
- traitement médicamenteux : Vertige.
- usage thérapeutique : Flunarizine, Inhibiteurs des canaux calciques.
- Adulte d'âge moyen, Association thérapeutique, Humains, Posture, Qualité de vie, Sujet âgé, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Calcium Channel Blockers, Flunarizine.
- drug therapy : Vertigo.
- therapy : Vertigo.
- Aged, Combined Modality Therapy, Follow-Up Studies, Humans, Middle Aged, Posture, Prospective Studies, Quality of Life.
Abstract
OBJECTIVES/HYPOTHESIS
The objective of the study was to evaluate the efficacy of three therapeutic strategies (Semont maneuver, flunarizine, and no treatment) in patients with benign paroxysmal positional vertigo.
STUDY DESIGN
Randomized prospective trial.
METHODS
One hundred fifty-six consecutive patients older than 60 years of age who were affected by benign paroxysmal positional vertigo of the posterior semicircular canal were enrolled. The diagnosis was made on the basis of the history of recurrent sudden crisis of vertigo and positional-induced typical nystagmus after Dix-Hallpike positioning maneuver. Patients were randomly allocated to receive Semont liberatory maneuver (intended as a statoconia-detachment maneuver), flunarizine, or no treatment. A post-treatment negative Dix-Hallpike test result was considered as a proof of vertigo resolution.
RESULTS
Cure rates with Semont maneuver were significantly higher (94.2%) than those obtained with flunarizine (57.7%) and no treatment (36.4%) (P <.001). Within a 6-month follow-up, relapse rates were lower among patients treated with Semont maneuver (3.8%) than those obtained with flunarizine (5.8%) and no treatment (21.1%). All patients with resolution of symptoms and negative Dix-Hallpike test results showed a great improvement in daily activities and quality of life (P <.001).
CONCLUSION
Semont liberatory maneuver is the most successful therapy for benign paroxysmal positional vertigo and improves patients' quality of life. Diagnostic and therapeutic maneuvers are easy to perform and should be part of the medical knowledge of every general practitioner and geriatrician.
DOI: 10.1097/00005537-200405000-00007
PubMed: 15126738
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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last="Trivelli">Maurizio Trivelli</name></author><author><name sortKey="Casale, Manuele" sort="Casale, Manuele" uniqKey="Casale M" first="Manuele" last="Casale">Manuele Casale</name></author><author><name sortKey="Firrisi, Luca" sort="Firrisi, Luca" uniqKey="Firrisi L" first="Luca" last="Firrisi">Luca Firrisi</name></author><author><name sortKey="Di Peco, Valerio" sort="Di Peco, Valerio" uniqKey="Di Peco V" first="Valerio" last="Di Peco">Valerio Di Peco</name></author><author><name sortKey="D Ascanio, Luca" sort="D Ascanio, Luca" uniqKey="D Ascanio L" first="Luca" last="D'Ascanio">Luca D'Ascanio</name></author><author><name sortKey="Greco, Fabio" sort="Greco, Fabio" uniqKey="Greco F" first="Fabio" last="Greco">Fabio Greco</name></author><author><name sortKey="Miele, Angela" sort="Miele, Angela" uniqKey="Miele A" first="Angela" last="Miele">Angela Miele</name></author><author><name sortKey="Petitti, Tommaso" sort="Petitti, Tommaso" uniqKey="Petitti T" first="Tommaso" 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uniqKey="Salvinelli F" first="Fabrizio" last="Salvinelli">Fabrizio Salvinelli</name><affiliation wicri:level="3"><nlm:affiliation>Department of Otolaryngology, Interdisciplinary Center for Biomedical Research, University Campus Bio-Medico, Catholic University of Sacred Heart, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Otolaryngology, Interdisciplinary Center for Biomedical Research, University Campus Bio-Medico, Catholic University of Sacred Heart, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Trivelli, Maurizio" sort="Trivelli, Maurizio" uniqKey="Trivelli M" first="Maurizio" last="Trivelli">Maurizio Trivelli</name></author><author><name sortKey="Casale, Manuele" sort="Casale, Manuele" uniqKey="Casale M" first="Manuele" last="Casale">Manuele Casale</name></author><author><name sortKey="Firrisi, Luca" sort="Firrisi, Luca" uniqKey="Firrisi L" first="Luca" last="Firrisi">Luca Firrisi</name></author><author><name sortKey="Di Peco, Valerio" sort="Di Peco, Valerio" uniqKey="Di Peco V" first="Valerio" last="Di Peco">Valerio Di Peco</name></author><author><name sortKey="D Ascanio, Luca" sort="D Ascanio, Luca" uniqKey="D Ascanio L" first="Luca" last="D'Ascanio">Luca D'Ascanio</name></author><author><name sortKey="Greco, Fabio" sort="Greco, Fabio" uniqKey="Greco F" first="Fabio" last="Greco">Fabio Greco</name></author><author><name sortKey="Miele, Angela" sort="Miele, Angela" uniqKey="Miele A" first="Angela" last="Miele">Angela Miele</name></author><author><name sortKey="Petitti, Tommaso" sort="Petitti, Tommaso" uniqKey="Petitti T" first="Tommaso" last="Petitti">Tommaso Petitti</name></author><author><name sortKey="Bernabei, Roberto" sort="Bernabei, Roberto" uniqKey="Bernabei R" first="Roberto" last="Bernabei">Roberto Bernabei</name></author></analytic><series><title level="j">The Laryngoscope</title><idno type="ISSN">0023-852X</idno><imprint><date when="2004" type="published">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Calcium Channel Blockers (therapeutic use)</term><term>Combined Modality Therapy (MeSH)</term><term>Flunarizine (therapeutic use)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Middle Aged (MeSH)</term><term>Posture (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Quality of Life (MeSH)</term><term>Vertigo (drug therapy)</term><term>Vertigo (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Association thérapeutique (MeSH)</term><term>Flunarizine (usage thérapeutique)</term><term>Humains (MeSH)</term><term>Inhibiteurs des canaux calciques (usage thérapeutique)</term><term>Posture (MeSH)</term><term>Qualité de vie (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Vertige (thérapie)</term><term>Vertige (traitement médicamenteux)</term><term>Études de suivi (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Calcium Channel Blockers</term><term>Flunarizine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Vertigo</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Vertigo</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Vertige</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Vertige</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Flunarizine</term><term>Inhibiteurs des canaux calciques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Combined Modality Therapy</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Posture</term><term>Prospective Studies</term><term>Quality of Life</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Association thérapeutique</term><term>Humains</term><term>Posture</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES/HYPOTHESIS</b></p><p>The objective of the study was to evaluate the efficacy of three therapeutic strategies (Semont maneuver, flunarizine, and no treatment) in patients with benign paroxysmal positional vertigo.</p></div><div type="abstract" xml:lang="en"><p><b>STUDY DESIGN</b></p><p>Randomized prospective trial.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>One hundred fifty-six consecutive patients older than 60 years of age who were affected by benign paroxysmal positional vertigo of the posterior semicircular canal were enrolled. The diagnosis was made on the basis of the history of recurrent sudden crisis of vertigo and positional-induced typical nystagmus after Dix-Hallpike positioning maneuver. Patients were randomly allocated to receive Semont liberatory maneuver (intended as a statoconia-detachment maneuver), flunarizine, or no treatment. A post-treatment negative Dix-Hallpike test result was considered as a proof of vertigo resolution.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Cure rates with Semont maneuver were significantly higher (94.2%) than those obtained with flunarizine (57.7%) and no treatment (36.4%) (P <.001). Within a 6-month follow-up, relapse rates were lower among patients treated with Semont maneuver (3.8%) than those obtained with flunarizine (5.8%) and no treatment (21.1%). All patients with resolution of symptoms and negative Dix-Hallpike test results showed a great improvement in daily activities and quality of life (P <.001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Semont liberatory maneuver is the most successful therapy for benign paroxysmal positional vertigo and improves patients' quality of life. Diagnostic and therapeutic maneuvers are easy to perform and should be part of the medical knowledge of every general practitioner and geriatrician.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">15126738</PMID><DateCompleted><Year>2004</Year><Month>06</Month><Day>18</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0023-852X</ISSN><JournalIssue CitedMedium="Print"><Volume>114</Volume><Issue>5</Issue><PubDate><Year>2004</Year><Month>May</Month></PubDate></JournalIssue><Title>The Laryngoscope</Title><ISOAbbreviation>Laryngoscope</ISOAbbreviation></Journal><ArticleTitle>Treatment of benign positional vertigo in the elderly: a randomized trial.</ArticleTitle><Pagination><MedlinePgn>827-31</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVES/HYPOTHESIS" NlmCategory="OBJECTIVE">The objective of the study was to evaluate the efficacy of three therapeutic strategies (Semont maneuver, flunarizine, and no treatment) in patients with benign paroxysmal positional vertigo.</AbstractText><AbstractText Label="STUDY DESIGN" NlmCategory="METHODS">Randomized prospective trial.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">One hundred fifty-six consecutive patients older than 60 years of age who were affected by benign paroxysmal positional vertigo of the posterior semicircular canal were enrolled. The diagnosis was made on the basis of the history of recurrent sudden crisis of vertigo and positional-induced typical nystagmus after Dix-Hallpike positioning maneuver. Patients were randomly allocated to receive Semont liberatory maneuver (intended as a statoconia-detachment maneuver), flunarizine, or no treatment. A post-treatment negative Dix-Hallpike test result was considered as a proof of vertigo resolution.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Cure rates with Semont maneuver were significantly higher (94.2%) than those obtained with flunarizine (57.7%) and no treatment (36.4%) (P <.001). Within a 6-month follow-up, relapse rates were lower among patients treated with Semont maneuver (3.8%) than those obtained with flunarizine (5.8%) and no treatment (21.1%). All patients with resolution of symptoms and negative Dix-Hallpike test results showed a great improvement in daily activities and quality of life (P <.001).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Semont liberatory maneuver is the most successful therapy for benign paroxysmal positional vertigo and improves patients' quality of life. Diagnostic and therapeutic maneuvers are easy to perform and should be part of the medical knowledge of every general practitioner and geriatrician.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Salvinelli</LastName><ForeName>Fabrizio</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology, Interdisciplinary Center for Biomedical Research, University Campus Bio-Medico, Catholic University of Sacred Heart, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trivelli</LastName><ForeName>Maurizio</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Casale</LastName><ForeName>Manuele</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Firrisi</LastName><ForeName>Luca</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Di Peco</LastName><ForeName>Valerio</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>D'Ascanio</LastName><ForeName>Luca</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Greco</LastName><ForeName>Fabio</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Miele</LastName><ForeName>Angela</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Petitti</LastName><ForeName>Tommaso</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Bernabei</LastName><ForeName>Roberto</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Laryngoscope</MedlineTA><NlmUniqueID>8607378</NlmUniqueID><ISSNLinking>0023-852X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D002121">Calcium Channel Blockers</NameOfSubstance></Chemical><Chemical><RegistryNumber>R7PLA2DM0J</RegistryNumber><NameOfSubstance UI="D005444">Flunarizine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002121" MajorTopicYN="N">Calcium Channel Blockers</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005444" MajorTopicYN="N">Flunarizine</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011187" MajorTopicYN="Y">Posture</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014717" MajorTopicYN="N">Vertigo</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2004</Year><Month>5</Month><Day>6</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2004</Year><Month>6</Month><Day>24</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2004</Year><Month>5</Month><Day>6</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">15126738</ArticleId><ArticleId IdType="pii">00005537-200405000-00007</ArticleId><ArticleId IdType="doi">10.1097/00005537-200405000-00007</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><noCountry><name sortKey="Bernabei, Roberto" sort="Bernabei, Roberto" uniqKey="Bernabei R" first="Roberto" last="Bernabei">Roberto Bernabei</name><name sortKey="Casale, Manuele" sort="Casale, Manuele" uniqKey="Casale M" first="Manuele" last="Casale">Manuele Casale</name><name sortKey="D Ascanio, Luca" sort="D Ascanio, Luca" uniqKey="D Ascanio L" first="Luca" last="D'Ascanio">Luca D'Ascanio</name><name sortKey="Di Peco, Valerio" sort="Di Peco, Valerio" uniqKey="Di Peco V" first="Valerio" last="Di Peco">Valerio Di Peco</name><name sortKey="Firrisi, Luca" sort="Firrisi, Luca" uniqKey="Firrisi L" first="Luca" last="Firrisi">Luca Firrisi</name><name sortKey="Greco, Fabio" sort="Greco, Fabio" uniqKey="Greco F" first="Fabio" last="Greco">Fabio Greco</name><name sortKey="Miele, Angela" sort="Miele, Angela" uniqKey="Miele A" first="Angela" last="Miele">Angela Miele</name><name sortKey="Petitti, Tommaso" sort="Petitti, Tommaso" uniqKey="Petitti T" first="Tommaso" last="Petitti">Tommaso Petitti</name><name sortKey="Trivelli, Maurizio" sort="Trivelli, Maurizio" uniqKey="Trivelli M" first="Maurizio" last="Trivelli">Maurizio Trivelli</name></noCountry><country name="Italie"><region name="Latium"><name sortKey="Salvinelli, Fabrizio" sort="Salvinelli, Fabrizio" uniqKey="Salvinelli F" first="Fabrizio" last="Salvinelli">Fabrizio Salvinelli</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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