Since effective treatment of PC-BPPV-cu has not been validated, a recent clinical guideline did not recommend specific treatment options based on the subtypes of PC-BPPV (canalolithiasis or cupulolithiasis) ( 5, 6). PC-BPPV-cu generates upward and ipsitorsional nystagmus, but the duration of symptoms and positional nystagmus are longer (over 1 min) than experienced with canalolithiasis of PC-BPPV (PC-BPPV-ca) ( 1– 4). Based on his theory, Barany's society formulated the diagnostic criteria of PC-BPPV-cu on 2015 ( 2).
Epley maneuver for vertigo Pc#
He suggested that half Hallpike maneuver can provoke persistent up and ipsitorsional nystagmus because the cupula of PC may be oriented along earth-horizontal axis, and thus the weighted cupula has maximal propensity to be deflected earthward ( 1). Epley previously described nystagmus characteristics and his clinical experience of diagnostic posture ( 1). Clear classification of PC-BPPV should be required at the time of different pathology and different treatment response.Ĭupulolithiasis of benign paroxysmal positional vertigo involving the posterior semicircular canal (PC-BPPV-cu) is a rare form of BPPV. 36%, p = 0.436) and the decrease of mSPV and DHI.Ĭonclusion: Neither the Epley maneuver nor BD exercise has an immediate therapeutic effect in treating PC-BPPV-cu. The Epley maneuver and BD exercise had an equivalent effect at 1 week in treating PC-BPPV-cu in terms of resolving positional nystagmus (48 vs. Results: Immediate resolution occurred in none of 29 patients in the Epley maneuver group and only 1 of 33 patients in the BD exercise group. Secondary outcomes included the resolution of positional nystagmus at 1 week, the change of maximal slow phase velocity (mSPV) of positional nystagmus, and dizziness handicap inventory (DHI) immediately and at 1 week. The primary outcome was an immediate resolution of positional nystagmus within 1 h after a single treatment of each maneuver on the visit day. Patients were randomly assigned to undergo the Epley maneuver ( n = 29) or BD exercise ( n = 33).
Epley maneuver for vertigo trial#
Methods: We conducted a randomized clinical trial to evaluate the therapeutic effect of the Epley maneuver and BD exercise in patients with PC-BPPV-cu. Objective: To investigate the therapeutic efficacies of the Epley maneuver and Brandt-Daroff (BD) exercise in patients with benign paroxysmal positional vertigo involving the posterior semicircular canal cupulolithiasis (PC-BPPV-cu).
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