BENIGN PAROXYSMAL POSITIONAL VERTIGO

Controlled Treatment Trials

Timothy C. Hain, MD • Page last modified: May 22, 2021

Main BPPV Page

More than 400 patients have been reported in blinded studies comparing the Epley or Semont maneuver to either placebo or medical treatment. The results are clearly in favor of these maneuvers. The median response in treated patients was 81%, compared to 37.% in placebo or untreated subjects. The few instances where the Epley or Semont results were not compelling (e.g. Blakely et al, 1994), may have been instances where technique was not perfected.

Study treated Response
percent
controls Response
percent
Response
total 402 217
median   81   37.5  
Froehling, Bowen et al. 2000 50 67 26 38 67% vs. 38% at 2 weeks
Li 1995 37 70 23 0 70% vs 0% at 1 week
Lynn, Pool et al. 1995 36 88 18 27 88% vs. 27% at 1 month
Blakley 1994 38 86 19 94 No statistical difference at 1 month
Wolf, Hertanu et al. 1999 41 75 10 50 75% response vs. 50% at 1 week
Fujino, Tokumasu et al. 1994 61 62 20 30 62% response vs. 30% at 2 weeks (p<.05)
Sherman and Massoud 2001 71 81 25 60 81% response v.s. 60% at 2 weeks(no statistical difference)
Simhadri et al (2003) 20 95 20 5 More recurrence in controls
Seo et al (2007) 18 67 16 6  
Salvanelli et al, 2003 40 92.5 40 37.5 Semont maneuver

Helminski et al (2010) published a meta-analysis of CRP in posterior canal BPPV. They concluded that there was very good evidence for efficacy of the Epley maneuver.

 

References