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ABSTRACT
Objective: The objective is to compare the efficacy of Epleys maneuver and vestibular sedative,
prochlorperazine maleate in the management of benign paroxysmal positional vertigo (BPPV).
Study Design: Randomized Control Trial.
Place and Duration of Study: ENT department, Combined Military Hospital, Rawalpindi from 1st May 2011 to
1st November 2011.
Patients and Methods: After consent, 60 patients of BPPV fulfilling the inclusion criteria were randomly
allotted two groups. Group A was treated with Epleys maneuver (n=30) while group B with
prochlorperazine maleate (n=30). Outcomes were analyzed on disappearance of vertigo at follow-up
examination.
Results: 24 (80%) cases managed by Epleys maneuver showed relief of symptoms while only 14 (47%) treated
by prochlorperazine maleate showed recovery after 15 days.
Conclusion: Epleys maneuver was more effective than vestibular sedatives like prochlorperazine maleate in
treating patients of BPPV.
Keywords: Benign Paroxysmal Positional Vertigo, Dix-Hallpike, Epleys Maneuver, Prochlorperazine
Maleate.
INTRODUCTION
Benign paroxysmal positional vertigo
(BPPV) is characterized by transient episodes
of vertigo associated with nystagmus,
precipitated by changes in head position with
respect to gravity1 . It is the most common
vestibular disease effecting women more
frequently than the men2. It can affect any age
group, with the peak incidence occurring in
the sixties and seventies3. The two main
hypothesis; which explain the development of
BPPV are the cupulolithiasis and canalithiasis
theory, which is based on the presence of freefloating debris in the lumen of the canal which
is the cause of vertigo4. It can be idiopathic
or secondary due to head trauma5,6
vestibular neuronitis menieres disease7 and
Cogans syndrome.
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Dix-HallpikeT
Patient was made to sit on a couch.
Examiner held the patients head turned to
450 towards right side and then placed the
patient in a supine position so that his head
hanged 300 below horizontal. Nystagmus or
vertigo was noticed in the patient. Procedure
was repeated for the left side.
Patients were randomly divided into 2 groups
of 30 each using random number table. Group
A was treated with EM.
Epleys maneuver
RESULTS
The mean age in group A was 41.67 7.92
years having minimum age of 28 and
maximum age of 55 years. In group B, mean
age was 42.38 9.897 years, ranging from 26
to 64 years. There were 23 (77%) females and 7
(23%) males in group A and 21 (70%) females
and 9 (30%) males in group B. Both the groups
are comparable with respect to age (p = 0.760)
and gender (p = 0.770).
DISCUSSION
The symptoms of BPPV are very
disturbing and can be disabling. Patients
affected can become so alarmed by the
symptoms that they do not get out of bed or
carry out their daily activities11, 12 and may
confuse it with stroke. Some present with
these symptoms to their primary care
physician13.
These
results
are
very
much
in
5.
6.
7.
8.
9.
10.
CONCLUSION
11.
12.
13.
14.
15.
CONFLICT OF INTEREST
16.
17.
REFERENCES
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1.
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3.
4.
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20.
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