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Maniobra de semont y ejercicios de rehabilitacion vestibular en el tratamiento del vertigo postural paroxistico benigno. Estudio comparativo (Semont maneuver and vestibular rehabilitation exercises in the treatment of benign paroxysmal postural vertigo. A comparative study) [Spanish]
Toledo H, Cortes ML, Pane C, Trujillo V
Neurologia 2000 Apr;15(4):152-157
clinical trial
2/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Benign paraoxysmal postural vertigo (BPPV) is one of the most frequent causes of peripheral dizziness. Treatment based on vestibular rehabilitation exercises (VRE) is effective in 90% of the cases in an interval of 3 to 4 weeks. This treatment however is often abandoned by the patient. The only therapeutic maneuvers (based on otolyte release) are equally effective but present a high medium term recurrence. AIM: To compare the efficacy of the Semont maneuver (SM), the VRE and the combination of both in the treatment of BPPV at three months of follow up. MATERIAL AND METHODS: Forty patients with the clinical and electronystagmographic diagnosis of BPPV were divided into three groups: (1) SM, (2) VRE and (3) SM+VRE. The results were compared in regard to the signs and symptoms observed in the three groups of patients at 15 days, one month and at three months of treatment. RESULTS: The SM was effective in 80% of the patients at 15 days of treatment versus 45% of those receiving only VRE. The third group of patients, receiving the combined treatment, demonstrated a cure in 100% of the cases when evaluated at three months while only 66% of the SM group were found to be asymptomatic at the same time period (p < 0.05). CONCLUSIONS: The SM is easy to perform, rapid and effective in the short term, however has high recurrence. The VRE are effective in the long term based on the patient persistence. Combination of the two treatment leads to symptom remission in 100% of the patients at three months of treatment.

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