title: A randomized clinical trial to assess the efficacy of the Epley maneuver in the treatment of acute benign positional vertigo.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA. achang@montefiore.org
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Chang
authors.forename: Gary
authors.initials: G
authors.lastname: Schoeman
authors.forename: MaryAnn
authors.initials: M
authors.lastname: Hill
mesh_terms: 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*
chemical_list: D006634:Histamine H1 Antagonists; D011398:Promethazine