title: Epley's maneuver in benign paroxysmal positional vertigo associated with Meniere's disease.
abstract: The effects of Epley's maneuver in benign paroxysmal positional vertigo (BPPV) associated with Menière's disease are controversial.
  
  
  OBJECTIVE
  To evaluate the progression of positional vertigo and nystagmus after one or more of Epley's maneuvers in BPPV associated with Menière's disease, and the recurrence of BPPV.
  
  
  METHODS
  a retrospective study of 62 patients with BPPV associated with Menière's disease, that underwent Epley's maneuver, and that were monitored during 12 months after elimination of positional nystagmus.
  
  
  RESULTS
  One Epley's maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after elimination of nystagmus, positional vertigo was suppressed in 71.0% of the patients, improved in 27.4% and remained unaltered in 1.6%. Four weeks after elimination of positional nystagmus, all patients were asymptomatic. Recurrence of BPPV was seen in 19.4% of the cases, with elimination of the positional vertigo and nystagmus by means of the specific maneuver for the involved canal.
  
  
  CONCLUSIONS
  In BPPV associated with Menière's disease, vertigo and positioning nystagmus were eliminated with one, two or three Epley maneuvers. BPPV recurrence was resolved by using a specific maneuver for the affected canal.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, 04025-001 Vila Clementino, SP. otoneuro@unifesp.epm.br
authors.forename: Cristina Freitas
authors.initials: CF
authors.lastname: Ganança
authors.forename: Heloisa Helena
authors.initials: HH
authors.lastname: Caovilla
authors.forename: Juliana Maria
authors.initials: JM
authors.lastname: Gazzola
authors.forename: Maurício Malavasi
authors.initials: MM
authors.lastname: Ganança
authors.forename: Fernando Freitas
authors.initials: FF
authors.lastname: Ganança
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D019416:Head Movements; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications*; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000628:therapy; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000628:therapy*