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A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department

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Journal of Otology 2021年第4期16卷 231-236页

作者： D.Giardino M.Musazzi M.Perez Akly M.Cherchi D.A.Yacovino Department of Neurology d Dr Cesar Milstein Hospital Buenos AiresArgentina Department of Neurology d Centro de Educacion Medica e Investigaciones Clínicas“Norberto Quirno”(CEMIC) Buenos AiresArgentina Department of Neurology d Feinberg School of Medicine Northwestern UniversityChicagoILUSA Chicago Dizziness and Hearing ChicagoILUSA Memory and Balance Clinic Buenos AiresArgentina

Introduction: Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the mostcommon cause of peripheral vertigo in the emergency department (ED). Although the canalith repositioning maneuver (CRM) is the standard of care, the most effective method to deliver it in the ED hasbeen poorly ***: To compare two protocols of the epley maneuver for the treatment of *** and methods: We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single epley maneuver (EM) (n ¼ 46) or multiple maneuvers(n ¼ 55) on the same visit. Measured outcomes included presence/absence of positional nystagmus,resolution of vertigo, and score on the dizziness handicap inventory (DHI) at follow-up evaluations. TheDHI was stratified into mild ( 30) and moderate-severe (>30).Results: Normalization of the Dix-Hallpike maneuver at day 5 was observed in 38% of the single EMgroup and 44.4% in the multiple EM group (p ¼ 0.62). The DHI showed reduction from 42.2 (SD 18.4) to31.9 (SD 23.7) in the single EM group and from 43.7 (SD 22.9) to 33.5 (SD 21.5) in the multiple EM group(p ¼ 0.06). A higher number of patients improved from moderate-severe to mild DHI (p ¼ 0.03) in thesingle EM group compared to the multi-EM group (p ¼ 0.23).Conclusion: There was no statistically significant difference between performing a single EM versusmultiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach isassociated with shorter physical contact between patients and examiner, which is logically safer in apandemic context.

关键词： Benign paroxysmal positional vertigo epley maneuver Emergency department Pandemic

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