Igor Levy Reis MD, Mohammad Kaleem Uddin MD, Timothy Carl Hain, MD
Northwestern University School of Medicine, Chicago IL 60611
The Epley maneuver (Epley, 1980) is a physical treatment for Benign Paroxysmal Positional Vertigo (BPPV). Most authors report that 80% or more of patients are significantly improved. Epley suggested that the maneuver be performed with vibration over the mastoid. Li (1995) recently reported that the maneuver with vibration is significantly more effective. However, this study was flawed because of a small comparison group of patients in whom no vibraiton was used (10 subjects). We performed the following study to compare a larger number of patients in order to answer the question whether vibration is helpful as an adjunctive procedure in the Epley maneuver.
A total of 100 patients with classic posterior-canal BPPV were studied. Vibration was used in 48 and no vibration was used in the remainder. Intensity of symptoms were quantified on a scale of 1-4 (mild- severe). Results were obtained through clinic followup, or with telephone calls if necessary. Results were categorized on a scale of 1-4 (cure-no change). We also determined whether there was a recurrence. Means for each group were compared using the 't'-test.
The average age was 57 years, ranging from 22-88. 75% of the patients were female. The median duration of symptoms was 1 month (range 2 days-10 years). There was no significant difference between age and sex distribution in the vibration vs. no-vibration groups.
In conclusion, our results suggest that the Epley maneuver is highly effective for the treatment of BPPV, but that vibration does not affect results significantly.
Presented at the American Academy of Neurology Annual Meeting, April, 1997