title: Vertigo during the Epley maneuver and success rate in patients with BPPV.
abstract: To investigate whether reported vertigo during the Epley maneuver predicts therapeutic success in patients with benign paroxysmal positioning vertigo of the posterior semicircular canal (pc-BPPV). Fifty consecutive adult patients with pc-BPPV, based on a positive Dix-Hallpike test (DHT), were treated with the Epley maneuver and retested after 2 days. Patients were asked to report the presence of vertigo upon assuming each of the four positions of the maneuver. Thirty seven patients (74 %) were treated successfully in one session. Twenty out of 23 patients who reported vertigo at turning the head to the opposite side (2nd position) had a negative DHT on follow-up. These patients had a higher chance of a successful outcome compared to patients who did not report vertigo in the 2nd position (Odds ratio 5.3, 95 % CI: 1.3-22.2, p = 0.022). Report of vertigo at the other positions was not associated with the outcome. Report of vertigo at the second position of a single modified Epley maneuver is associated with therapeutic success.
authors.affiliation: 1st Academic Department of Otolaryngology Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, S.Kiriakidi 1, 54636 Thessaloniki, Greece. drfirbas@hotmail.com
authors.forename: Georgios
authors.initials: G
authors.lastname: Fyrmpas
authors.forename: Eustathios
authors.initials: E
authors.lastname: Barkoulas
authors.forename: Anna Bettina
authors.initials: AB
authors.lastname: Haidich
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Tsalighopoulos
mesh_terms: D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010037:Otolithic Membrane / Q000503:physiopathology; D056888:Patient Positioning / Q000379:methods*; D012665:Semicircular Canals / Q000503:physiopathology; D016896:Treatment Outcome; D014717:Vertigo / Q000503:physiopathology / Q000628:therapy*