A randomized clinical trial to assess the efficacy of the Epley maneuver in the treatment of acute benign positional vertigo.
OBJECTIVE
To compare the efficacy of the Epley maneuver with that of a placebo maneuver in patients presenting to the emergency department (ED) with benign positional vertigo (BPV).


METHODS
This was a prospective, randomized, single-blind placebo-controlled trial. Consecutive adult ED patients presenting to a university teaching hospital with BPV were randomized to treatment with either the Epley or placebo maneuver. The severity of vertigo was evaluated on a 0 to 10-point scale before and after the maneuvers.


RESULTS
Eleven patients were randomized to the Epley group and 11 to the placebo group before the trial was terminated, based on a planned interim analysis. The median decreases in vertigo severity were 6 (95% confidence interval [95% CI] = 4 to 9) for the Epley group and 1 (95% CI = 0 to 3) for the placebo group (p = 0.001).


CONCLUSIONS
The Epley maneuver is a simple bedside maneuver that appears to be more efficacious than a placebo maneuver in the treatment of acute BPV among ED patients.
Chang
Andrew K
AK
Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA. achang@montefiore.org
Schoeman
Gary
G
Hill
MaryAnn
M
D000208:Acute Disease; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011187:Posture; D011398:Promethazine / Q000627:therapeutic use; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D014717:Vertigo / Q000145:classification / Q000209:etiology / Q000628:therapy*
D006634:Histamine H1 Antagonists; D011398:Promethazine