Head-Shaking for PC-BPPV-cu
Trial question
What is the effect of head-shaking maneuver in patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
63.0% female
37.0% male
N = 106
106 patients (67 female, 39 male).
Inclusion criteria: patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo.
Key exclusion criteria: age < 20 years; multicanal benign paroxysmal positional vertigo; cervical spine problems; cognitive dysfunction.
Interventions
N=53 head-shaking maneuver (after pitching the head forward by 30°, the head was moved laterally at a sinusoidal rate of approximately 3 Hz for 15 seconds while seated).
N=53 sham maneuver (patients lay on the unaffected side and returned to a sitting position after 1 minute).
Primary outcome
Rate of short-term resolution rate of positional vertigo and nystagmus the following day
37.7%
13.2%
37.7 %
28.3 %
18.9 %
9.4 %
0.0 %
Head-shaking
maneuver
Sham
maneuver
Significant
increase ▲
NNT = 4
Significant increase in the rate of short-term resolution rate of positional vertigo and nystagmus the following day (37.7% vs. 13.2%; OR 2.86, 95% CI 1.32 to 6.18).
Secondary outcomes
No significant difference in immediate efficacy of maneuver within 30 minutes (11.3% vs. 3.8%; AD 7.5%, 95% CI -7.74 to 22.74).
Safety outcomes
No significant difference in adverse events.
Conclusion
In patients with cupulolithiasis of posterior canal benign paroxysmal positional vertigo, head-shaking maneuver was superior to sham maneuver with respect to the rate of short-term resolution rate of positional vertigo and nystagmus the following day.
Reference
Eun Hye Oh, Jae-Hwan Choi, Hyun Sung Kim et al. Treatment Maneuvers in Cupulolithiasis of the Posterior Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial. JAMA Netw Open. 2025 Mar 3;8(3):e250972.
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