Short-term efficacy of Epley's manoeuver for benign paroxysmal positional vertigo: a randomised double-blind placebo-controlled trial

BackgroundEvidence on the effectiveness of the Epley manoeuvre in primary care is scarce.AimTo evaluate effectiveness at 1 week, 1 month, and 1 year of a single Epley manoeuvre versus a sham manoeuvre in primary care.Design and settingMulticentre, double-blind randomised controlled trial in two primary care practices in Spain from November 2012 to January 2015.MethodPatients were ≥18 years diagnosed with subjective or objective posterior benign paroxysmal positional vertigo (vertigo only, or vertigo and nystagmus after a Dix–Hallpike test [DHT]). The intervention group received the Epley manoeuvre, and the control group received a sham manoeuvre. Betahistine was prescribed following the same regimen in both groups. The main outcome measures were the DHT result classified as negative (neither vertigo nor nystagmus) or positive. Positive results were further divided into a positive result for both vertigo and nystagmus (positive DHT with nystagmus), and a positive result for vertigo only (positive DHT without nystagmus); self-reported resolution of vertigo; and self-reported severity of vertigo evaluated on a 10-point Likert scale (10 = worst imaginable vertigo).ResultsIn total, 134 patients were randomised to either the intervention group (n = 66) or the sham group (n = 68). The intervention group showed better results in the unadjusted analyses at 1 week, with a lower rate of positive DHT with nystagmus (P = 0.022). A positive baseline DHT with nystagmus was associated with a reduction in vertigo severity (marginal effect for 10-point Likert-like question −1.73, 95% confidence interval [CI] = −2.95 to −0.51) and better positive DHT rates in the intervention group (adjusted odds ratio 0.09, 95% CI = 0.01 to 0.92) in the multivariate analyses.ConclusionA single Epley manoeuvre performed in primary care is an effective treatment for reversing a positive DHT and reducing vertigo severity in patients with baseline nystagmus in the DHT.

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Correction: Epley manoeuvre for posterior semicircular canal benign paroxysmal positional vertigo in people with multiple sclerosis: protocol of a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-046510corr1 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1.3-1

Keyword(s):

Multiple Sclerosis ◽

Randomised Controlled Trial ◽

Semicircular Canal ◽

Benign Paroxysmal Positional Vertigo ◽

Controlled Trial ◽

Posterior Semicircular Canal ◽

Positional Vertigo ◽

Randomised Controlled ◽

Paroxysmal Positional Vertigo

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The efficacy of Epley and Semont maneuvers in posterior semicircular canal benign paroxysmal positional vertigo treatment: A short-term comparative study

Praxis of Otorhinolaryngology ◽

10.5606/kbbu.2021.73645 ◽

2021 ◽

Vol 9 (3) ◽

pp. 75-80

Author(s):

Mustafa Caner Kesimli

Keyword(s):

Comparative Study ◽

Semicircular Canal ◽

Benign Paroxysmal Positional Vertigo ◽

Posterior Semicircular Canal ◽

Short Term ◽

Positional Vertigo ◽

Epley Maneuver ◽

The One ◽

Paroxysmal Positional Vertigo

OBJECTIVE: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. METHODS: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. RESULTS: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and one-month follow-ups (p=0.002, p<0.001, p=0.001, respectively). CONCLUSION: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigo.

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