Benign paroxysmal positional vertigo (BPPV), characterized by episodes of intense vertigo cause nausea, blurred vision, and falls. The most effective treatments have not yet been determined. No studies have systematically compared the accepted treatments to sham treatments while comparing systematic in treatment parameters or the influence of co- morbidity from other medical conditions. The clinical studies detailed in this application examine these accepted treatments and a control treatment to determine the immediate short-and long-term effectiveness of treatments for BPPV. The following specific aims will be addressed: 1) Determine the relative effectiveness of the Eply maneuver, the Semont maneuver, and Brandt-Daroff exercises compared to each other and to sham treatment in reducing the intensity and frequency of vertigo episodes and oculomotor responses to Dix-Hallpike maneuvers, and in increasing independence in activities of daily living; 2) Determine the relative effectiveness of habituation exercises designed to facilitate central habituation of vertigo, exercises designed to remove otoconial matter from the semicircular canals and the sham treatment; 3) Determine the relative contributions of variations on the most effective treatment from Specific Aim 2; 4) Determine the effect of co-morbid conditions on short-and long- term response to treatment.
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