Vijayendra Simha N1, Yenamadala Sobhan2
ABSTRACT: BACKGROUND/AIM: Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders characterized with brief attacks of vertigo, with associated nystagmus, precipitated by certain changes in head position with respect to gravity. The majority of patients have posterior SCC BPPV, while about 15 percent have the lateral SCC variant. The superior variant is rare. The aim of this study is to assess the clinical and symptomatic improvement in BPPV patients after performing Epleys maneuver. MATERIALS AND METHODS: A one year observational clinical study review was conducted on diagnosed BPPV patients in 65 patients from July 2013 to July 2014. Patients with Dix Hallpike test positive and subsequently an Epleys maneuver performed were selected. Demographic data, clinical history and examination, treatment plan information was collected and analyzed. The patients were followed up at the intervals of 7 and 14 days. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. STATISTICAL TESTS: chi-square test, Fischer test. RESULTS: 65 patients were selected randomly with Dix Hallpike positive test and confirmed to have BPPV. According to severity of symptoms and observation on Dix Hallpike test, Epleys maneuver was performed once or twice. 41 patients reported a complete resolution in 1st week follow up. 16 patients reported a complete resolution in the 2nd week follow up after a repeat Epleys maneuver. 8 patients reported a partial resolution of symptoms after 2nd week, were advised for a home exercise of Brandt Daroff exercises was considered as the failure group. This was statistically analysed using chi-square and fisher test. CONCLUSION: Epleys manuver is an effective treatment for BPPV of posterior SCC, with an overall effectiveness quotient of 87.7%. It is effective when, either repeated in one or two sessions, with a single or repeat manuever at the same sitting. Other studies have shown that repeated treatment may improve the remission rate. The Epleys manuever performed two times in the same sitting was comparatively more effective with a success rate of 92.4% than performed with a success rate of 86%.
