著者

鈴木 衞

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.2, pp.79-89, 2014-04-30 (Released:2014-06-01)

被引用文献数

2

著者

笹 征史

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.58, no.1, pp.1-8, 1999 (Released:2009-12-07)

参考文献数

7

---

Neurotransmissions between neurons and via nerves to effector organs and from the peripheral apparatus to afferent fibers are mediated by neurotransmitters. These chemicals are composed of small molecular neurotransmitters including acetylcholine, monoamines such as dopamine, norepinephrine, serotonin, histamine and amino acids (GABA, glycine, glutamate) and large molecular transmitters (peptides such as substance P and neurokinnin). These neurotransmitters are stored in vesicles incorporated within the nerve terminals and are released by exocytosis upon arrival of impulses to the terminals resulting in Ca2+ influx. The neurotransmitters bind to selective receptors and are taken up into the nerve terminals by transporters. Receptors are composed of channel types such as nicotinic, 5-HT3, GABAA, glycine and glutamate receptors and G protein-coupled types. The latter receptors (ex: muscarinic, dopaminergic receptors) with 7-fold transcrossed-amino acids are composed of two second messenger-mediated groups via cAMP and IP3/DG, which activate protein kinase A and C, respectively. Second messengers produce a variety of responses including the iron-channel mechanism in the cell. The structure-activity relationship and receptor specificity is currently an important issue in drug research. One neurotransmitter usually acts on several kinds of receptor subtypes, therefore specific subtype receptor antagonists could be developed as potential candidates of therapeutic drugs.

著者

一般社団法人日本めまい平衡医学会 診断基準化委員会 担当理事: 飯田 政弘 池園 哲郎 伊藤 彰紀 委員長:武田 憲昭 副委員長:中村 正 委員:渡辺 行雄 重野 浩一郎 鶴岡 尚志 浅井 正嗣 山本 昌彦 武井 泰彦 今井 貴夫 池田 卓生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.74, no.2, pp.126-133, 2015-04-30 (Released:2015-06-01)

参考文献数

5

被引用文献数

1 1

著者

佐藤 豪

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.74, no.3, pp.213-217, 2015-06-30 (Released:2015-08-01)

参考文献数

13

被引用文献数

2

著者

高木 恭也 村上 力夫 伊藤 八次 五島 桂子 松原 茂規 小島 俊己 宮田 英雄 時田 喬

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.49, no.2, pp.240-248, 1990 (Released:2009-10-13)

参考文献数

26

被引用文献数

2

---

To clarify the peculiarities of gait disturbances in patients with labyrinthine, cerebellar and spinal disturbances, head movements and activity of the soleus muscles were studied during walking.The upward-downward (U-D), right-left (R-L) and forward-backward (F-B) movements of the head and activities of both soleus muscles were recorded by a polygraph with the aid of a five-channel telemeter. Head movements were recorded with three accelerometers attached to a helmet that the subject wore. Muscle activities was recorded by EMG with surface electrodes. At the same time the subject's foot-floor contact sequence was measured with electric switches in the shoes. These gait data were recorded on a pen oscillograph.1) In normal subjects, head movement recording revealed regular U-D movement and F-B inclination twice in each walking cycle and regular R-L inclination once in each walking cycle. Each soleus muscle was activated at the stance phase once in each walking cycle.2) A patient with unilateral labyrinthine disorder had head movements with irregular rhythm and ampulitude. L-R inclination of the head was not related to foot contact. The soleus muscle activities increased in the swing phase and decreased in the stance phase.3) A patient with bilateral loss of labyrinthine excitability had small, indistinct head movements with no relation to foot contact or foot raising. The record of the soleus muscle activities indicated plolongation of the active time and overlap of the activities of the two sides.4) A patient with spino-cerebellar degeneration had very irregular, unequal head movements, especially excessive F-B head movement. The active time of the soleus muscles was prolonged.5) A patient with left hemiparesis due to cervical myelopathy had small, irregular U-D and F-B head movements and large, sine wave like sway in R-Lhead movements. The soleus muscle activity of the left side in the stance phase was less than that of the right side. The record of the electric foot switch indicated that the subject often missed foot raising of her left leg.

著者

吉田 忠雄 加藤 正大 大竹 宏直 加藤 健 寺西 正明 片山 直美 中島 務

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.72, no.4, pp.247-253, 2013-08-01

被引用文献数

2

---

Development of 3-tesla enhanced magnetic resonance imaging (MRI) provides a tool for the visualization of endolymphatic hydrops (EH). This technique was first developed in animal experiments and adapted in patients with inner ear diseases including Menieres disease (MD). Up to the present, we have demonstrated EH in many MD patients. Recently, we have succeeded in obtaining a 3D-real IR-like image even after intravenous standard-dose gadolinium administration. This type of image was named the HYDROPS (HYbriD of Reversed image Of Positive endolymph Signal and native image of positive perilymph signal). The relationship between unilateral MD and EH has not yet been explored. We studied 76 patients with unilateral MD who were evaluated using MRI. The mean age of the subjects was 53.4 years (range 17 to 80 years). Forty-two were women and 34 were men. Symptomatic and non-symptomatic ears were categorized into 4 groups (healthy, 76; possible, 48; Probable, 13; and definite, 15) based on AAO-HNS definitions. MRI was performed 4 hours after intravenous gadolinium administration. Overall, 152 ears were evaluated. EH in the cochlea was present in 57 of 76 symptomatic ears (73.7%) and 34 of 76 (44.7%) non symptomatic ears. Ears with definite MD had EH more frequently in the cochlea than ears in the healthy ears groups. Furthermore, EH in the vestibule with definite MD was larger than ears in any of the other groups. Our reports showed for the first time that there was Ba relationship between the degrees of EH and the stage of MD. Moreover, in fewer than half of unilateral MD patients EH was seen in the cochlea with non-symptomatic ears. EH in healthy ears may be an indicator of bilateral MD. Using MRI to identify this covert EH in asymptomatic patients may offer the possibility of early detection or prevention of MD.

著者

國弘 幸伸 中山 明峰

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.6, pp.465-472, 2011 (Released:2012-02-01)

参考文献数

14

---

Along with Epley's canalith repositioning maneuver, the Semont maneuver is also recognized as an effective physical therapy for benign paroxysmal positional vertigo. However, the details of this maneuver are not well known, presumably because of the obscurity of the original description by Semont et al. In Japan, the “Semont liberatory maneuver,” as described by Brandt, is accepted as the “original” Semont maneuver. However, the two maneuvers are not identical. The aim of this paper was to reproduce the original procedure of Semont's as presented by A. Semont himself at the 10th Nagoya Otorhinolaryngological Forum held in Nagoya, Japan, in 2006. This lecture clarified some obscure points in the original paper; however, the procedure described at the forum was not a detailed reproduction of the original Semont maneuver, but was somewhat more complicated. Also of note, Semont decisively denied the cupulolithiasis theory and explained the usefulness of his maneuver according to the canalolithiasis theory.

著者

小宮山 櫻子 中原 はるか 津田 幸子 吉村 恵理子 室伏 利久

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.72, no.6, pp.493-500, 2013-12-31 (Released:2014-02-01)

参考文献数

17

被引用文献数

2 2

---

The purposes of this study was to elucidate the clinical characteristics of patients suffering from migraine-associated vertigo (MAV) including results of cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP). Thirty patients diagnosed as having MAV based on the diagnostic criteria by Sakata et al. were enrolled. We performed a retrospective chart review. These patients underwent medical history taking and examinations including cVEMP, oVEMP and a caloric test. All examinations were performed during a symptom-free interval. Twenty one patients (70%) experienced rotatory vertigo, 5 patients (17%) had floating dizziness and 4 patients (13%) had both. Twenty six patients (87%) reported tinnitus and/or aural fullness unilaterally or bilaterally. Their vertigo or dizziness lasted under 60 minutes in 10 patients (34%), 1 hour to 24 hours in 14 patients (46%), and over one day in 5 patients (17%). Canal paresis in the caloric test was observed in 5 patients (17%). Concerning cVEMP, 4 of the 30 patients (13%) showed absent cVEMPs bilaterally, 2 patients (7%) showed absent cVEMPs reflexes unilaterally, and one (3%) demonstrated decreased cVEMP amplitudes unilaterally. Only one patient showed prolonged cVEMP latencies. Concerning oVEMP, 6 of the 30 patients (20%) had absent oVEMP reflexes bilaterally, 2 (7%) had absent oVEMP reflexes unilaterally, and one (3%) had decreased oVEMP amplitudes unilaterally. In 2 patients prolonged oVEMP latencies were observed. No significant correlation was observed among cVEMP, oVEMP and the caloric test. This study showed abnormal vestibular reflexes could be shown by oVEMP as well as the caloric test and cVEMP. It was suggested that a portion of those patients with MAV have abnormal otolith-ocular reflexes.

著者

内藤 泰

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.63, no.3, pp.262-266, 2004-06-01

被引用文献数

1

著者

福嶋 宗久 北原 糺 堀井 新 道場 隆博 大園 芳之 今井 隆介

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.1, pp.16-21, 2014-02-28 (Released:2014-04-01)

参考文献数

13

被引用文献数

1

---

We have recently encountered two cases of intractable Meniere's disease with a history of head trauma. Both patients underwent surgical treatments because conservative medical treatment had failed. As we supposed that they had developed a secondary endolymphatic hydrops associated with perilymphatic fistula, we first performed a simple mastoidectomy and opened the facial recess to carry out an exploratory tympanotomy. Next, we performed endolymphatic sac drainage and closed both oval and round windows with connective tissue whether we found an obvious fistula or not. One year-follow-up results showed complete relief from vertigo after the operation in both cases. It is suggested that relative increase in the endolymph pressure can become a cause of endolymphatic hydrops due to the decline of the perilymph pressure. In patients with Meniere's disease who have a history of trauma, we propose that it should be better to keep in mind the possibility of fistula-induced secondary hydrops.

著者

石井 正則

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.63, no.2, pp.67-80, 2004 (Released:2009-06-05)

参考文献数

36

---

Various factors are involved in the onset of motion sickness. As an investigation of one of those factors, the spatial orientation of experimental subjects was changed, and the relationship to the development of motion sickness was examined. For an objective study, it is necessary to establish an experimental model of motion sickness. Accordingly, artificial visual field information was created, and a computer capable of highspeed calculation was used to stimulate the experimental subjects with images undergoing temporal or spatial changes. Individual experimental subjects showed considerable variation in the development of motion sickness. Thus, it was important to perform the experiments on highly susceptible subjects. The results showed that, when for both time and space, the phase was asynchronized, motion sickness manifested at a high incidence. At the time motion sickness is manifested, there is always abnormal secretion of hypothalamus-pituitary-adrenal axis hormones and the development of symptoms of autonomic nervous system instability. For this reason, it can be surmised that there is involvement of emotions and the autonomic nervous system as a result of changes in spatial orientation. It can be thought that this is due to a state of asynchronization of the intrinsic information that leads to motor commands. In particular, information from an intrinsic model with unanticipated asynchronization of eye movement and head movement is important. The relationships among spatial orientation, head-eye movement, the memory process and emotion in the manifestation of motion sickness is discussed.

著者

鈴木 衞

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.65, no.2, pp.91-103, 2006-04-01

参考文献数

90

被引用文献数

3 3

---

Canalolithiasis and cupulolithiasis have been proposed to be causative mechanisms of BPPV. Anatomical and physiological features of otoconia are reviewed. Three layers, the columnar fibers, gelatin membrane, and otolithic membrane, are known as overlaying structures on the macular sensory epithelia. The supporting cell plays an essential role in otoconial formation. It secretes granules containing calcium as a precursor of otoconia. A number of proteins are involved in the production and growth of otoconia, such as Otoconin-90 and CB-D28K. Alterations of the endolymphatic environment, ototoxic drugs, carbonic anhydrase, hormones, aging, or gene mutation lead to degeneration or deformity of otoconia. Hydrodynamic and physiological features of otoconia existing within the semicircular canal or attaching to the cupula have been studied using mathematical models and amphibian semicircular canals. These studies showed that canalolithiasis is potentially the most relevant mechanism of BPPV in terms of the long latency and short duration of nystagmus. Human temporal bone sections had been studied to demonstrate deposits on the cupula or within the canal lumen. Otoconia were also found in the posterior canal lumen that was opened during canal plugging surgery. Clarification of the basic characters of otoconia is essential for elucidating the clinical picture of BPPV.

著者

伊保 清子 浅野 和江 村山 真弓 阿久津 二夫 長沼 英明 徳増 厚二 岡本 牧人

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.2, pp.67-76, 2011 (Released:2011-06-01)

参考文献数

13

---

Appearance of the dominant peak-frequency in body sways during standing was retrospectively investigated in patients with spinocerebellar degeneration (SCD). Subjects tested were 25 patients with SCD (16 men and 9 women, ranging in age from 25 to 80; mean 55.8±15.4 yr). The disease types comprised SCA3 (n=5), SCA 6 (n=3), MSA-C (n=12), and an unknown type (n=5). Stabilometry was performed in each patient, who was asked to stand upright with a closed stance, with eyes open and eyes closed, using Anima's stabilometer G6100. The sampling time was 50 ms (20Hz) and the correcting time was 60 s. The peak-frequency was measured based on the power spectrum using the maximum entropy method (MEM). Total locus length, envelope area and velocity-vector of movement of the center of foot-pressure were also measured.The first or main peak appeared in a low frequency range between 0.10 and 0.59Hz in most of the cases with eyes open and eyes closed. It was detected in the lateral direction in 24 patients of the total number (96.0%) and in the anterior-posterior direction in 22 patients of the total (88.0%).The body sway of a frequency of 3Hz was detected in 4 patients (16.0%). Among them, the peak in the lateral direction was observed in 2 (8.0%) with eyes open or closed (one with SCA 6 and one with an unknown disease type). The peak in the anterior-posterior direction was detected in 3 (12.0%) with eyes open or closed (one each with SCA 6, MSA-C and an unknown disease type); in these subjects, the values of the total locus length divided by envelope area were more than 40.The dominant peak-frequency of 3Hz in body sways during standing did not frequently appear in patients with SCD, but it is suggested to be one of characteristic balance disorders in the disease.

著者

高橋 正紘

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.3, pp.204-211, 2011 (Released:2011-08-01)

参考文献数

39

被引用文献数

1 2

---

I have investigated lifestyles, behavior patterns, causative factors, and progression of hearing loss in many patients with Meniere's disease, and found that lack of recompense for pressure of business, patience or service is responsible for the onset or progression of the disease. Further, aerobic exercise proved very effective to stop vertigo and improve fixed hearing loss. Three years ago, I advocated a new therapy for Meniere's disease consisting of aerobic exercise and countermeasures to remove the harmful factors in daily life (aiming at good sleep, omission, and relaxation). Because the new therapy has been far more effective than any conventional therapies, we must renew the treatment concept of and therapeutic strategy for Meniere's disease. I suspect the possibility that the CNS emotional center, stimulated by lack of recompense against stress in activities of daily living, influences the hypothalamus, which in turn reduces blood flow to the inner ear, and produces endolymphatic hydrops. Aerobic exercise, together with correction of irregular or inactive lifestyles, removes unhealthy factors, improves the subject's general physical condition, and finally cures endolymphatic hydrops.

著者

伊藤 信輔 井上 望 平野 実

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.45, no.3, pp.281-283, 1986 (Released:2009-06-05)

参考文献数

7

被引用文献数

1

---

Slow eye movement induced by a vestibulo-ocular reflex was enhanced or inhibited in various postures of rabbits. A tonic neck reflex functions to help pursuit eye movement in both active and passive postures.

著者

有国 富夫

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.62, no.4, pp.284-301, 2003 (Released:2009-06-05)

参考文献数

39

---

Recently, many functional areas have been identified in the parietal cortex of the brain in monkeys, and owing to this, cytoarchitectonic subdivision has been elaborated in the monkey parietal cortex. This review deals with sulcal patterns of the parietal lobe in human and monkey brains, and corticocortical connections of both neurophysiologi-cally defined regions and cytoarchitectonic areas of the parietal cortex in monkeys. The author proposes that the transverse occipital sulcus is a boundary between the parietal and occipital cortices in the human brain. A brain map of the monkey is presented. The parietal cortical areas are subdivided into somatosensory, eye movement related, hand or upper limb movement related, vestibular, and auditory areas, according to neu-rophysiologically defined functions of individual cortical areas. The somatosensory system contains areas 3a, 3b, 1, 2, 5, 7b, and SII: S1 projects to motor and premotor areas and somatosensory association areas project to premotor areas, the prefrontal, temporal, and limbic cortices, and the hippocampus. The eye movement system is composed of areas 7a, LIP, and PIP: It receives input from visual and temporal cortices and sends output to premotor areas, the prefrontal cortex, and the hippocampus. Hand movements are mediated in areas AIP, VIP, CIP, MIP, PEc, and V6A: These areas receive afferents from somatosensory areas, visual and temporal cortices and send efferents to the ventral premotor area. The vestibular functions are executed by coordination of areas 3aNV, 3aHV, 2NV, Ri, and VPS: These areas reciprocate with the cingulate cortex and insula and project to the ventral premotor area, SWA, and frontal eye field. The auditory system involves areas VIP and LIP: It receives afferents from the superior temporal sulcal cortex and sends efferents to the premotor area, frontal eye field, and prefrontal cortex.

著者

有國 富夫

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.62, no.4, pp.284-301, 2003-08-01

---

Recently, many functional areas have been identified in the parietal cortex of the brain in monkeys, and owing to this, cytoarchitectonic subdivision has been elaborated in the monkey parietal cortex. This review deals with sulcal patterns of the parietal lobe in human and monkey brains, and corticocortical connections of both neurophysiologi-cally defined regions and cytoarchitectonic areas of the parietal cortex in monkeys. The author proposes that the transverse occipital sulcus is a boundary between the parietal and occipital cortices in the human brain. A brain map of the monkey is presented. The parietal cortical areas are subdivided into somatosensory, eye movement related, hand or upper limb movement related, vestibular, and auditory areas, according to neu-rophysiologically defined functions of individual cortical areas. The somatosensory system contains areas 3a, 3b, 1, 2, 5, 7b, and SII: S1 projects to motor and premotor areas and somatosensory association areas project to premotor areas, the prefrontal, temporal, and limbic cortices, and the hippocampus. The eye movement system is composed of areas 7a, LIP, and PIP: It receives input from visual and temporal cortices and sends output to premotor areas, the prefrontal cortex, and the hippocampus. Hand movements are mediated in areas AIP, VIP, CIP, MIP, PEc, and V6A: These areas receive afferents from somatosensory areas, visual and temporal cortices and send efferents to the ventral premotor area. The vestibular functions are executed by coordination of areas 3aNV, 3aHV, 2NV, Ri, and VPS: These areas reciprocate with the cingulate cortex and insula and project to the ventral premotor area, SWA, and frontal eye field. The auditory system involves areas VIP and LIP: It receives afferents from the superior temporal sulcal cortex and sends efferents to the premotor area, frontal eye field, and prefrontal cortex.

著者

藤原 文明 朴沢 二郎 新川 秀一 一條 宏明 西村 哲也

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.49, no.2, pp.263-270, 1990

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Delayed endolymphatic hydrops (DEH) was proposed by Nadol (1975) and Schuknecht (1976) as a pathological diagnosis. Because of severe hearing loss, the presence of endolymphatic hydrops (EH) cannot be demonstrated by the glycerol test or electro-cochleography. This paper discusses a clinical method of examining EH in this disease. The authors' earlier study, reported in Acta Otolaryngol (Stockh) suppl. 435 (1987), showed that EH in Meniere's disease could be detected not only by audiometry but also by the trapezoid rotation test. The demonstration of ipsilateral labyrinthine preponderance (LPi) by this rotation test is a useful indicator of the development of EH. The authors performed this rotation test in seven patients who satisfied Schuknecht's criteria of DEH by careful history taking and audiometry, and LPi was detected in five of them, especially before the onset of vertigo. It was concluded that the detection of LPi by the trapezoid rotation test should be added to the tests used for the exact diagnosis of DEH.

著者

犬飼 賢也 高橋 紳一郎 肥塚 泉

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.1, pp.17-22, 2011 (Released:2011-04-01)

参考文献数

24

---

Although the duration of benign paroxysmal positional vertigo (BPPV) is generally short, it can sometimes be long and intractable. We report on a case of intractable BPPV in which the duration of disease was four years. The patient was a 38-year-old woman. She had suffered from bilateral hearing loss since childhood. Since October 2005, she experienced severe vertigo whenever she turned her head. She had consulted other doctors, but the symptoms persisted. On June 20, 2007, she was referred to the Otolaryngology Department of Tachikawa General Hospital. The positional nystagmus test demonstrated apogeotropic nystagmus in a bilateral position with a duration of more than one minute. Upbeat nystagmus with a clockwise direction (from the examiner) was seen in sitting position using the Dix-Hallpike method. A pure tone audiogram showed high tone damage causing sensorineural hearing loss bilaterally. A caloric test did not show canal paresis. Magnetic resonance imaging (MRI) of the brain showed normal findings. MRI of the inner ears showed narrowing throughout the entire semicircular canal bilaterally (mainly the bilateral anterior semicircular canals). The Brandt-Daroff method induced nausea; therefore that examination method was abandoned. Habitual training advocated by St. Marianna University, the Head shaking method from Yamaguchi University, and the Non-specific training method from Toho University did not improve the nystagmus. Vestibular training by Kitazato University improved her vertiginous feeling. The direction of nystagmus changed variously during the course. The vertiginous feeling had almost disappeared in June 2009, but nystagmus persisted. We considered that cupulolithiasis in the bilateral lateral semicircular canals often shifted to canalolithiasis in various portions of the semicircular canals. Appropriate physical therapy improved the subjective symptoms.

著者

倉島 一浩 國弘 幸伸 齋藤 晶 上村 隆一郎 小林 宏成 神崎 仁

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium research (ISSN:03855716)

巻号頁・発行日

vol.56, no.6, pp.560-568, 1997-12-01

被引用文献数

4 1

---

We retrospectively determined the efficacy of Semont's liberatory maneuver in 52 patients with benign paroxysmal positional vertigo (BPPV). Vertigo and torsional nystagmus, characteristic of BPPV, had been induced by the Hallpike maneuver at the time of diagnosis.<BR>Thirty of these patients were treated by Semont's maneuver after being informed in detail about the method. If vertigo reoccurred after treatment, they repeated the maneuver at home twice a day (after awaking and before going to bed) until vertigo disappeared. Patients received no medication and were followed until complete remission or for up to 1 year. The other 22 patients received either no treatment or were treated with medication only; they were followed for up to 9 years.<BR>Disappearance of nystagmus was ascertained for the first group only at our dizziness clinic. While most of these patients exhibited nystagmus lasting‹30 seconds (indicating the mechanism of canalolithiasis), two had nystagmus lasting›1 minute, a sign of cupulolithiasis-induced BPPV. Complete remission of BPPV occurred in 28 patients in the first group or 93.3%; 19 (68%) of these patients showed remission within 3 days. In the second group, the vertigo was resolved in only 9 of the 22 patients (40.9%). The difference in the remission rate of the two groups was significant (p<0.0001).<BR>Our results proved the efficacy of Semont's maneuver for treating not only the more common type of BPPV caused by canalolithiasis but also the less common type induced by cupulolithiasis.