Objective: This study aimed to explore the clinical characteristics of the automatic vestibular function therapy system (SRM-IV) fully automated benign paroxysmal positional vertigo (BPPV) diagnosis and treatment system in the treatment of refractory BPPV and evaluate the clinical effect of reduction therapy. Methods: The clinical data of 39 patients with refractory BPPV who were admitted to our hospital's department of neurology from January 2020 to May 2022 were analyzed retrospectively. Results: Eighteen, 14, and 5 patients were cured after 3, 4, and 5 reduction treatments, respectively, with the SRM-IV vertigo diagnosis and treatment system. Another 2 patients were unable to recover through canalith repositioning procedure, although they improved after alternating between manual repositioning and Brandt-Daroff habituation training. Conclusions: Most patients with refractory BPPV were cured after canalith repositioning procedure. The causes of intractability might involve many different aspects. Longer disease history and poor otolith mobility are also one of the reasons for this difficulty.
Keywords: canalith repositioning procedure; intractability; vertigo.