سرگیجه وضعیتی بیماری خوشخیم ومعمولا نیازی به درمان ندارد.درمان دارویی فقط برای کنترل حالت تهو وسرگیجه شدید داده می شود.
مانور های که بطور شایع در بهبودی بیمار مبتلا به سرگیجه خوشخیم وضعیتی موثر می باشد و بیمار می تواند در منزل بکار گیرد به استثناأ کسانی که بیماری قلبی یا اختلالات گردنی دارند شامل:
HOME TREATMENT OF BPPV:
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The Brandt-Daroff Exercises are a home method of treating BPPV, usually used when the side of BPPV is unclear. Their use has been declining in recent years, as the home Epley maneuver (see below) is considerably more effective. They succeed in 95% of cases but are more arduous than the office treatments. These exercises also may take longer than the other maneuvers -- the response rate at one week is only about 25% (Radke et al, 1999). These exercises are performed in three sets per day for two weeks. In each set, one performs the maneuver as shown five times.
1 repetition = maneuver done to each side in turn (takes 2 minutes)
|Suggested Schedule for Brandt-Daroff exercises
Start sitting upright (position 1). Then move into the side-lying position (position 2), with the head angled upward about halfway. An easy way to remember this is to imagine someone standing about 6 feet in front of you, and just keep looking at their head at all times. Stay in the side-lying position for 30 seconds, or until the dizziness subsides if this is longer, then go back to the sitting position (position 3). Stay there for 30 seconds, and then go to the opposite side (position 4) and follow the same routine.
These exercises should be performed for two weeks, three times per day, or for three weeks, twice per day. This adds up to 42 sets in total. In most persons, complete relief from symptoms is obtained after 30 sets, or about 10 days. In approximately 30 percent of patients, BPPV will recur within one year. Unfortunately, daily exercises are not effective in preventing recurrence (Helminski and Hain, 2008). The Brandt-Daroff exercises as well as the Semont and Epley maneuvers are compared in an article by Brandt (1994), listed in the reference section.
When performing the Brandt-Daroff maneuver, caution is advised should neurological symptoms (i.e. weakness, numbness, visual changes other than vertigo) occur. Occasionally such symptoms are caused by compression of the vertebral arteries (Sakaguchi et al, 2003). In this situation we advise not proceeding with the exercises and consulting ones physician.
Multicanal BPPV (usually mild) often is a consequence of using the Brandt-Daroff exercises.
HOME EPLEY MANEUVER
The Epley and/or Semont maneuvers as described above can be done at home (Radke et al, 1999; Furman and Hain, 2004). We often recommend the home-Epley to our patients who have a clear diagnosis. This procedure seems to be even more effective than the in-office procedure, perhaps because it is repeated every night for a week.
The method (for the left side) is performed as shown on the figure to the right. One stays in each of the supine (lying down) positions for 30 seconds, and in the sitting upright position (top) for 1 minute. Thus, once cycle takes 2 1/2 minutes. Typically 3 cycles are performed just prior to going to sleep. It is best to do them at night rather than in the morning or midday, as if one becomes dizzy following the exercises, then it can resolve while one is sleeping. The mirror image of this procedure is used for the right ear.