Vojnosanitetski pregled 2012 Volume 69, Issue 8, Pages: 669-674
https://doi.org/10.2298/VSP1208669B
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Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal
Babac Snežana (Klinika za otorinolaringologiju Kliničko-bolničkog centra „Zvezdara“, Beograd)
Arsović Nenad (Institut za ORL i maksilofacijalnu hirurgiju, Klinički centar Srbije, Beograd)
Background/Aim. Benign paroxysmal positional vertigo is one of the most
frequent peripheral vestibular system disorders. The aim of this study was to
examine the efficacy of the Epley maneuver in treating benign paroxysmal
positional vertigo of the posterior semicircular canal (p- BPPV) and to
discover possible causes of failure. Methods. This prospective study included
75 patients. In all the cases medical history showed and the positioning
Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed
clinical ENT examination, searching for spontaneous nystagmus,
vestibulospinal tests, caloric test, and audiometry. All the patients were
treated by the modified Epley canalith repositioning maneuver. The patients
were followed up at the intervals of seven and, fourteen days, and one, tree,
and six months and one year. The maneuver was repeated if vertigo and
nystagmus on control positioning test persisted. The transition from positive
into negative Dix Hallpike test after one or two Epley maneuver was
considered as success in treatment. Results. After the initial Epley maneuver
the recovery rate was 90.7%, and after the second 96%. In three (4%) patients
with secondary p-BPPV, symptoms did not cease even after the second
repositioning maneuver. The etiology of p-BPPV had a significant effect on
the maneuver’s success rate (p < 0.01), whereas duration of symptoms, age and
gender had no effect (p > 0.05). After a successful treatment 11 (14.66%)
patients had recurrent attack of BPPV during the first year. Conclusion. The
Epley maneuver is very successful repositioning procedure in treating p-
BPPV. The patients with idiopathic form p-BPPV showed higher success rate
with Epley maneuver than those with secondary p-BPPV.
Keywords: vertigo, diagnosis, physical therapy modalities, treatment outcome