![]() Rotational nystagmus is typical: four to five second latency and duration of 30 to 40 seconds. We have a positive maneuver when it triggers vertigo and nystagmus when the patient changes posture from sitting to laying down with his/her head hanging downwards horizontally, with a 45° head turn towards the tested side 3,5,6. ![]() However, some patients experience recurrent symptoms months or even years later, which may vary from short spells to decades of suffering, with short remission spans 5.ĭix-Hallpike maneuver aids in diagnosis. Symptoms tend to spontaneously resolve after a few weeks or months. Because of its clinical characteristics, patients feel fearsome, and both vertigo as well as triggering head movements might considerably limit their daily activities 5. The interview reveals a typical history with short vertigo spells at head movements 4. It is clinically characterized by recurrent vertigo spells, usually triggered by certain head movements or patient's change in posture 3.ĭiagnosis is clinical. There is scientific evidence showing good efficacy of Epley's maneuver in the treatment.īenign paroxysmal positional vertigo (BPPV) is one of the most frequent vestibular disorders 1,2. ![]() There are no studies about the efficacy of Semont's maneuver. The metaanalysis showed positive evidence of Epley's maneuver to the posterior semicircular canal (effect size = 0.11 of objective improvement within one week, 0.24 within one month and 0.16 of improvement reported by the patients within one week. We found five controlled clinical trials phase I comparing the Epley's maneuver with controls or placebo. The trials were assessed using Jadad's scale and only studies with quality scores equal or above 3 were pooled on a meta-analyses to assess their effectiveness. The main outcome was Dix-Hallpike negative test and the changes to subjective complaints. The trials should have included physical maneuvers such as Epley and Semont. MethodologyĪn electronic search at the main databases, including MEDLINE, LILACS, PEDro, Cochrane Collaborations Database was performed, and we selected only randomized clinical trials studying adults with diagnosis of BPPV confirmed by the Dix-Hallpike test. To asses the effectiveness of the specific maneuvers available to the treatment of BPPV. ![]() There are several approaches for treatment, but efficacy is still being discussed. Benign Paroxysmal Positional Vertigo (BPPV) is one of the most frequent diseases of the vestibular system and it is characterized by episodes of recurrent vertigo triggered by head movements or position changes.
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