efficacy of Epley manoeuver in the treatment of posterior canal paroxysmal positional vertigo

ABSTRACT

Benign paroxysmal positional vertigo is the most common peripheral vestibular disorder. Canalith repositioning manoeuvers are an established method for treatment of this disorder but efficacy of these maneuvers, including Epley canalith repositioning manoeuver are reported differently in various studies. In this study the efficacy of the Epley canalith repositioning maneuver has been evaluated in 43 patients. 43 patients with a history and physical examination consistent with posterior canal benign paroxysmal positional vertigo were studied. Patients were treated with a modified Epley canalith repositioning manoeuver. Patients were provided with a preprinted diary in which they had to circle the answers most relevant to their symptoms for 7 days after the manoeuver. Patients were reevaluated at one week after the manoeuver, The Hallpike manoeuver was performed at this time to corroborate the response to therapy. The mean duration of the BPPV before treatment was 7 weeks. A resolution of vertigo as a result of the manoeuver was obtained during the first 24 hours in 59% of the patients after one canalith repositioning manoeuver. 20% of patients had a resolution of vertigo during the first week however it is not evidently possible to conclude that these patients definitely benefited from the canalith repositioning manoeuver. In 21% of the patients vertigo persisted after the first week. Residual symptoms of lightheadedness, imbalance or both, were frequent [55% of cases] but rarely required any intervention. Epley canalith repositioning manoeuver resulted in immediate resolution of vertigo in 59% of our cases after one treatment. This manoeuver is safe and requires no special equipment or investigations; and it should be regarded as the treatment of choice for BPPV