To demonstrate that for treatment of benign positional vertigo it is not necessary to identify a positional nystagmus. Study Design: Prospective trial of 43 patients with positional vertigo without clinical evidence of positional nystagmus who were treated with a modified canal-repositioning maneuver. Methods: Results were compared with the results obtained in the treatment of posterior semicircular cupolo-canalithiasis with typical positional nystagmus with the same repositioning maneuver. Results: Treatment of 43 patients with positional vertigo without positional nystagmus resulted in a 60.46% (26/43) complete recovery rate and a 6% (3/43) persistence of disorder rate compared with a 90% complete recovery rate obtained in 90 patients with typical benign positional paroxysmal vertigo (with positional nystagmus). Conclusions: What is attempted by this work is to confirm that through clinical evaluation based on history and positioning tests alone, one can obtain acceptable results in treatment of supposed canalithiasis without having detected the pathognomonic nystagmus.
