Self-Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Preliminary Study.

Zhuangqin Gan,Ya Bai,Junliang Han,Feng He,Hui Yang,Dong Wei,Yuanyuan Wang,Wei Fu,Shiling Zhou,Yingxia Wang

doi:10.3389/fmed.2021.654637

Abstract

Objectives: The purpose of this study is to investigate a modified Epley maneuver for self-treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV).Methods: The study recruited 155 patients with PC-BPPV. All patients were randomized into the Epley maneuver group (n = 77) and modified Epley maneuver group (n = 78). We analyzed the resolution rate (1 day and 1 week), residual symptoms after the maneuver, and adverse effects.Results: It was found that the modified Epley maneuver group had a higher resolution rate than that of the Epley maneuver group in the treatment of PC-BPPV after 1 day of the initial maneuver (p < 0.05). However, there was no difference in resolution rate between the Epley maneuver group and the modified Epley maneuver group in resolution rate after 1 week of the initial maneuver (p > 0.05). The modified Epley maneuver group had fewer residual symptoms than that of the Epley maneuver group 1 week after treatment of PC-BPPV (p < 0.05). Significant improvements were also observed in average DHI scores in patients who underwent the modified Epley maneuver compared to the Epley maneuver (p < 0.05). There was no significant difference in adverse effects between the two groups (p > 0.05).Conclusions: The modified Epley maneuver has a satisfactory therapeutic efficacy with less residual symptoms and could be recommended as a self-treatment for patients with PC-BPPV.

Highlights

Benign paroxysmal positional vertigo (BPPV) is the common cause of peripheral vertigo
One day after the initial maneuver, 58 (75.32%) patients reported resolution and 19 (24.68%) patients reported ineffective in the Epley maneuver group
One week after the initial maneuver, 71 (92.21%) patients reported resolution, and 6 (7.79%) patients reported ineffective in the Epley maneuver group

Summary

Introduction

Benign paroxysmal positional vertigo (BPPV) is the common cause of peripheral vertigo. It is usually caused by otoconia that are dislodged from the otolith macula beds and become trapped in the semicircular canal [1]. 60-90% of BPPV involves the posterior canal (PC-BPPV) [2]. PC-BPPV is usually diagnosed by the means of the Dix–Hallpike test, which is considered positive when it triggers vertigo symptoms as well as torsional and vertical nystagmus [3]. Treatment of PC-BPPV relies on a canalith repositioning maneuver, and the most common approach is the Epley maneuver [4].

Objectives

Results

Conclusion