Epley's maneuver in benign paroxysmal positional vertigo associated with Meniere's disease

Cristina Freitas Ganança, Heloisa Helena Caovilla, Juliana Maria Gazzola, Maurício Malavasi Ganança, Fernando Freitas Ganança
Brazilian Journal of Otorhinolaryngology 2007, 73 (4): 506-12

UNLABELLED: The effects of Epley's maneuver in benign paroxysmal positional vertigo (BPPV) associated with Menière's disease are controversial.

AIMS: 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.

METHOD: 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.

CONCLUSION: 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.

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