Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-09T15:24:07.112Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term follow up after Epley's manoeuvre in patients with benign paroxysmal positional vertigo

Published online by Cambridge University Press:  20 May 2008

U M Rashad
U M Rashad*
Affiliation:
Department of ENT, Faculty of Medicine, Assuit University, Egypt
*
Address for correspondence: Dr Usama M Rashad, Department of Surgery, ENT Sector, Al Ahsaa-College of Medicine, King Faisal University, Saudi Arabia. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To assess the long-term efficacy of Epley's manoeuvre performed to treat benign paroxysmal positional vertigo.

Patients and methods:

Two hundred and sixty-nine patients suffering benign paroxysmal positional vertigo were offered Epley's manoeuvre. After five years, follow up was arranged. One hundred and three patients attended for follow up (58 women and 45 men; age range 19–65 years). As mentioned 269 patients were offered the EM and 103 of them were available for follow up. Prior to initial Epley's manoeuvre treatment, these patients' duration of benign paroxysmal positional vertigo had ranged from four to 96 weeks.

Results:

Five years after treatment of benign paroxysmal positional vertigo with Epley's manoeuvre, 65 per cent of patients reported no further attacks. Kaplan–Meier testing showed that the time to recurrence was significantly longer in patients aged less than 40 years, those with a duration of attacks of less than three years prior to initial Epley's manoeuvre treatment, and those suffering less than six exacerbations prior to initial Epley's manoeuvre treatment. Gender had no effect on time to recurrence. Duration of illness before receiving Epley's manoeuvre was the only independent predictor of recurrence.

Conclusion:

Epley's manoeuvre remains an effective modality for treatment of benign paroxysmal positional vertigo. A patient age of less than 40 years and duration of attacks of less than three years are good prognostic factors. Exacerbation number and gender do not affect the probability of benign paroxysmal positional vertigo recurrence after five years; however, these factors do affect the duration of time free from the condition.

Keywords

Positional VertigoPhysical Therapy Techniques
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 1 , January 2009 , pp. 69 - 74
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Yimtae, K, Srirompotong, S, Srirompotong, S. A randomized trial of the canalith repositioning procedure. Laryngoscope 2003;113:828–33CrossRefGoogle ScholarPubMed
2 Hilton, M, Pinder, D. The Epley's manoeuvre for benign paroxysmal positional vertigo – a systematic review. Clin Otolaryngol Allied Sci 2002;27:440–5CrossRefGoogle ScholarPubMed
3 Epley, JM. The canalith repositioning procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107:399–404CrossRefGoogle ScholarPubMed
4 Radtke, A, Neuhauser, H, von Brevern, M. A modified Epley's procedure for self-treatment of benign paroxysmal positional vertigo. Neurology 1999;53:1358–60CrossRefGoogle ScholarPubMed
5 Herdman, SJ, Tusa, RJ, Zee, DS. Single treatment approaches to benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 1993;119:450–4CrossRefGoogle ScholarPubMed
6 Froehling, D, Bowen, J, Mohr, D. The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial. Mayo Clin Proc 2000;75:695–700CrossRefGoogle ScholarPubMed
7 Wolf, M, Hertanu, T, Novikov, I. Epley's manoeuvre for benign paroxysmal positional vertigo: a prospective study. Clin Otolaryngol 1999;24:43–6CrossRefGoogle ScholarPubMed
8 Cohen, H, Jerabek, J. Efficacy of treatments for posterior canal benign paroxysmal positional vertigo. Laryngoscope 1999;109:584–90CrossRefGoogle ScholarPubMed
9 Asawavichianginda, S, Isipradit, P, Snidvongs, K. Canalith repositioning for benign paroxysmal positional vertigo: a randomized, controlled trial. Ear Nose Throat J 2000;79:732–4, 736–7CrossRefGoogle ScholarPubMed
10 Prokopakis, EP, Chimona, T, Tsagournisakis, M, Christodoulou, P, Hirsch, B, Lachanas, VA et al. Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure. Laryngoscope 2005;115:1667–71CrossRefGoogle ScholarPubMed
11 Macias, JD, Lambert, KM, Massingale, S. Variables affecting treatment in benign paroxysmal positional vertigo. Laryngoscope 2000;110:1921–4CrossRefGoogle ScholarPubMed
12 Radtke, M, von Brevern, K, Tiel-Wilck, A, Mainz-Perchalla, H, Neuhauser, MPH, Lempert, T. Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure. Neurology 2004;63:150–2CrossRefGoogle ScholarPubMed
13 Parnes, LS, Price-Jones, RG. Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otorhinolaryngol 1993;102:325–31Google ScholarPubMed
14 Minor, LB, Zee, DS. Evaluation of the patient with dizziness. In: Hurley, R, ed. Otolaryngology Head and Neck Surgery, 3rd edn. U.S.A.: Geoff Greenwood, 1998;2634–53Google Scholar
15 Brandt, T, Huppert, D, Hecht, J, Karch, C, Strupp, M. Benign paroxysmal positioning vertigo: A long-term follow-up (6–17 years) of 125 patients. Acta Otolaryngol 2006;126:160–3CrossRefGoogle ScholarPubMed
16 Lopez-Escamez, JMG, Gamiz, MJ, Fernandez-Perez, A, Gomez-Fiñana, M. Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 2005;262:507–11CrossRefGoogle ScholarPubMed