epley maneuver for benign positional vertigo

EPLEY MANEUVER FOR BENIGN POSITIONAL VERTIGO UPDATE

None of the trials comparing Epley versus other particle repositioning manoeuvres reported vertigo resolution as an outcome. Complete resolution of vertigo Complete resolution of vertigo occurred significantly more often in the Epley treatment group when compared to a sham manoeuvre or control (odds ratio (OR) 4.42, 95% confidence interval (CI) 2.62 to 7.44 five studies, 273 participants) the proportion of patients resolving increased from 21% to 56%. Eight of the trials blinded the assessors to the participants' treatment group and data on all outcomes for all participants were reported in eight of the 11 studies. All studies were randomised with six applying sealed envelope or external allocation techniques. All patients were adults aged 18 to 90 years old, with a sex ratio of 1:1.5 male to female.There was a low risk of overall bias in the studies included. Patients were treated in hospital otolaryngology departments in eight studies and family practices in two studies. We included 11 trials in the review with a total of 745 patients.Five studies compared the efficacy of the Epley manoeuvre against a sham manoeuvre, three against other particle repositioning manoeuvres (Semont, Brandt-Daroff and Gans) and three against a control (no treatment, medication only, postural restriction). We used the standard methodological procedures expected by The Cochrane Collaboration.

Secondary outcomes were conversion of a 'positive' Dix-Hallpike test to a 'negative' Dix-Hallpike test and adverse effects of treatment. The primary outcome of interest was complete resolution of vertigo symptoms. Randomised controlled trials of the Epley manoeuvre versus placebo, no treatment or other active treatment for adults diagnosed with posterior canal BPPV (including a positive Dix-Hallpike test). The date of the most recent search was 23 January 2014. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register CENTRAL PubMed EMBASE CINAHL Web of Science Cambridge Scientific Abstracts ICTRP and additional sources for published and unpublished trials. To assess the effectiveness of the Epley manoeuvre for posterior canal BPPV. Current treatment approaches include rehabilitative exercises and physical manoeuvres, including the Epley manoeuvre.

It is a common cause of vertigo presenting to primary care and specialist otolaryngology clinics.

EPLEY MANEUVER FOR BENIGN POSITIONAL VERTIGO UPDATE

This is an update of a Cochrane Review first published in The Cochrane Library in Isand previously updated in 20.Benign paroxysmal positional vertigo (BPPV) is a syndrome characterised by short-lived episodes of vertigo in association with rapid changes in head position.

Epley maneuver for benign positional vertigo