Effect of the Epley Maneuver and Brandt-Daroff Exercise on Benign Paroxysmal Positional Vertigo Involving the Posterior Semicircular Canal Cupulolithiasis: A Randomized Clinical Trial

• Published in: Frontiers in neurology 2020-12, Vol.11, p.603541-603541
• Main Authors: Choi, Seo-Young, Cho, Jae Wook, Choi, Jae-Hwan, Oh, Eun Hye, Choi, Kwang-Dong
• Format: Article
• Language: English
• Subjects: benign paroxysmal positional vertigo; Brandt-Daroff exercise; cupulolithiasis; Epley maneuver; Neurology; nystagmus; vertigo
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2020.603541

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). We conducted a randomized clinical trial to evaluate the therapeutic effect of the Epley maneuver and BD exercise in patients with PC-BPPV-cu. Patients were randomly assigned to undergo the Epley maneuver ( = 29) or BD exercise ( = 33). The primary outcome was an immediate resolution of positional nystagmus within 1 h after a single treatment of each maneuver on the visit day. 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. Immediate resolution occurred in none of 29 patients in the Epley maneuver group and only 1 of 33 patients in the BD exercise group. 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. 36%, = 0.436) and the decrease of mSPV and DHI. Neither the Epley maneuver nor BD exercise has an immediate therapeutic effect in treating PC-BPPV-cu. Clear classification of PC-BPPV should be required at the time of different pathology and different treatment response.