Roll you on the affected side so the side where you are experiencing the worst vertigo - is facing upward and holds it in position for up to two minutes.Move your head in the other direction until it is 30 degrees away from the table and hold you in place for up to two minutes or until dizziness stops.Your doctor will hold your head in this position for up to two minutes or until your dizziness subsides.Your head will be positioned at a 30-degree angle and lifted slightly off the table. Position your head to face the affected side of your body.Forcefully push you back to the table so that your shoulder blades touch the table.Instruct you to extend your legs out in front of you, while you sit on an exam table.What to expect during the Epley maneuverĭuring the Epley maneuver, your doctor will perform the following steps: ![]() The Epley Maneuver is a generally safe procedure with few or no risks. Once you have seen the Epley maneuver performed by a doctor, you can perform it at home to relieve your symptoms. Generally, the Epley maneuver is not recommended for patients who have vertigo from other conditions, such as migraines, ear infections, anemia, or a cerebellar stroke. Your doctor may perform the Epley maneuver to help patients who are experiencing dizziness and nausea associated with BPPV. Most people experience long-term and short-term symptom relief from the therapy. Trial Registration ClinicalTrials.An Epley maneuver is a series of movements used to relieve symptoms of BPPV.ĭuring the Epley maneuver, your doctor will use movements to reposition crystals in your ear that may be causing dizziness and nausea. Nineteen patients (19.6%) in the EM group and 24 (24.5%) in the SM-plus group experienced relevant nausea.Ĭonclusions and Relevance The SM-plus self-maneuver is superior to the EM self-maneuver in terms of the number of days until recovery in pcBPPV. No serious adverse event was detected with both maneuvers. For the secondary end point (effect of a single maneuver), no significant difference was detected (67 of 98 vs 61 of 97 P = .42 α = .05). The mean (SD) time until no positional vertigo attacks could be induced in the SM-plus group was 2.0 (1.6) days (median, 1 day 95% CI, 1.64-2.28 days) in the EM group, 3.3 (3.6) days (median, 2 days 95% CI, 2.62-4.06 days) ( P = .01 α = .05, 2-tailed Mann-Whitney test). Results Of the 195 participants included in the analysis, the mean (SD) age was 62.6 (13.9) years, and 125 (64.1%) were women. The secondary end point was the effect of the single maneuver performed by the physician. The primary end point was the number of days until no positional vertigo could be induced on 3 consecutive mornings. Main Outcome and Measures Patients had to document whether they could provoke positional vertigo every morning. Interventions After being randomized to the SM-plus or the EM group, patients received 1 initial maneuver from a physician, then subsequently performed self-maneuvers at home 3 times in the morning, 3 times at noon, and 3 times in the evening. The analysis was prespecified and per-protocol. After consideration of the exclusion criteria as well as informed consent, 56 patients were excluded and 2 declined to participate, with 195 participants included in the final analysis. Two hundred fifty-three patients were assessed for eligibility. Patients were selected randomly during routine outpatient care after being referred to 1 of the 3 centers. ![]() Recruitment took place from June 1, 2020, until March 10, 2022. ![]() Objective To compare the effectiveness of the Semont-plus maneuver (SM-plus) and the Epley maneuver (EM) for treatment of posterior canal benign paroxysmal positional vertigo (pcBPPV) canalolithiasis.ĭesign, Setting, and Participants This prospective randomized clinical trial was performed at 3 national referral centers (in Munich, Germany Siena, Italy and Bruges, Belgium) over 2 years, with a follow-up to 4 weeks after the initial examination. Importance Questions remain concerning treatment efficacy for the common condition of benign paroxysmal positional vertigo (BPPV).
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