Benign Paroxysmal Positional Vertigo and Epley Maneuver

Benign Paroxysmal Positional Vertigo and Epley Maneuver What is benign paroxysmal positional vertigo? Some parts of your ear help you with hearing. Some parts of your ear help you with balance. The part of your ear that controls balance is called the semi-circular canal. You have a semi-circular canal in the inner part of each ear. In some people, sand-like particles or crystals called canaliths in the inner ear become loose and move around. This causes dizziness which is also called vertigo. What is the Epley Maneuver? This is a series of steps you can do at home to help reposition the canaliths and help dizziness. Step 1: Sit up straight in the middle of your bed. Step 2: Turn your head 45 degrees toward the ear that is causing your symptoms and hold the position for 1 full minute: For problems with your right ear, turn your head to the right. For problems with your left ear, turn your head to the left. Step 3: Keep your head and neck at this 45 degree angle and gently lie down flat on your back. Hold this position for 1 minute even if you feel dizzy. Step 4: While still lying flat on your back slowly rotate your head towards your good ear as far as you can or about 90 degrees. Hold this position for 1 full minute even if you feel dizzy. Step 5: With your head still in this position, slowly roll the rest of your body toward your good side so that your body and head lie in the same direction. Bracing yourself with one hand, roll forward slightly so you can turn your face toward the floor. Hold this position for 1 minute. Step 6: Slowly return to a sitting position with your head up but flexed forward about 45 degrees. Hold this position for 1 minute. Important: Each series of steps should take about 5 minutes to do. You should do 3 complete series of steps before going to bed. Move slowly from one position to another. If you have a headache or feel weak, numb or have vision changes, stop the Epley Maneuver and get medical help. Other things you can try to help: Prop your head on pillows when sleeping. Avoid extending your head and neck backwards until you feel better. PD 8567 (03-2014) File: peyles .

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Effectiveness of the Epleys Maneuver for Treatment of Benign Paroxysmal
Effectiveness of the Epleys Maneuver for Treatment of Benign Paroxysmal Positional Vertigo Salah Uddin Ahmmed1, Md Zakir Hossain2,Mohammad Neser Uddin2, Sarder Mohammad Golam Rabbani2, Arba Md Shaon Mursalin Alman3. Abstract Background: Benign Paroxysmal Positional Vertigo (BPPV) is one of the most frequent vestibular disorder. It is characterized by recurrent spells of vertigo associated with certain head movements such as turning the head to right or left, getting out of bed, looking up and bending down. Objectives: The aim of this study was to compare the efficacy of treatment by the Epley maneuver with medicine and medicine (betahistine) only for benign paroxysmal positional vertigo. Materials and Methods: Fifty six patients with benign paroxysmal positional vertigo were randomly divided in two groups. One group was treated with Epley maneuver wth medicine as case and other group with only medicine (betahistine) as control. Results: At the end of first week who were treated with Epley maneuver with medicine, 24 (85.71%) patients recovered and 27 (96.42%) were recovered at second week and all the 28 (100%) were found recovered at end of third week. Whereas, who treated with betahistine only 7(25.00%) recovered at end of first week 22 (78.58%) recovered at second week, 25 (89.29%) recovered at third week and all the 28 (100%) were at end of fourth week. Who received only medical therapy needed one more extra visit than case patients Conclusion: Treatment of BPPV with the Epleys manouvre with medicine resulted in early better and improvement of symptoms than with medicine alone. Keywords: Benign paroxysmal positional vertigo, Epleys manouvre, betahistine.
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Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo
OTOXXX10.1177/0194599816689667Otolaryngology–Head and Neck SurgeryBhattacharyya et al 6896672017© The Author(s) 2010 Reprints and permission: sagepub.com/journalsPermissions.nav Clinical Practice Guideline Otolaryngology– Head and Neck Surgery Clinical Practice Guideline: Benign 2017, Vol. 156(3S) S1 –S47 © American Academy of Otolaryngology—Head and Neck Paroxysmal Positional Vertigo (Update) Surgery Foundation 2017 Reprints and permission: sagepub.com/journalsPermissions.nav DOI:https://doi.org/10.1177/0194599816689667 10.1177/0194599816689667 http://otojournal.org Neil Bhattacharyya, MD1, Samuel P. Gubbels, MD2, Seth R. Schwartz, MD, MPH3, Jonathan A. Edlow, MD4, Hussam El-Kashlan, MD5, Terry Fife, MD6, Janene M. Holmberg, PT, DPT, NCS7, Kathryn Mahoney8, Deena B. Hollingsworth, MSN, FNP-BC9, Richard Roberts, PhD10, Michael D. Seidman, MD11, Robert W. Prasaad Steiner, MD, PhD12, Betty Tsai Do, MD13, Courtney C. J. Voelker, MD, PhD14, Richard W. Waguespack, MD15, and Maureen D. Corrigan16 Sponsorships or competing interests that may be relevant to content are associated with undiagnosed or untreated BPPV. Other out- disclosed at the end of this article. comes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary re- turn physician visits, and maximizing the health-related quality Abstract of life of individuals afflicted with BPPV. Action Statements. The update group made strong recommenda- Objective. This update of a 2008 guideline from the American tions that clinicians should (1) diagnose posterior semicircular Academy of Otolaryngology—Head and Neck Surgery Foun- canal BPPV when vertigo associated with torsional, upbeating dation provides evidence-based recommendations to benign nystagmus is provoked by the Dix-Hallpike maneuver, per- paroxysmal positional vertigo (BPPV), defined as a disorder of formed by bringing the patient from an upright to supine posi- the inner ear characterized by repeated episodes of position- tion with the head turned 45° to one side and neck extended al vertigo.
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A Practical Approach to Assessment and Treatment of Benign Paroxysmal Positional Vertigo Combining research and Clinical Practice Naseem Chatiwala, PT, DPT, MS, NCS Board certified Neuro Clinical Specialist Certified Vestibular Specialist Workshop Objectives • Analyze normal and abnormal anatomy and physiology of the vestibular system • Recognize signs and symptoms of BPPV and confidentially identify variants of BPPV • Explain physiologic rationale of test procedures and results of various test for BPPV • Utilize results of clinical examination to develop treatment plans • Be able to identify treatment procedure Overview • In the USA, 1.7 million people sustain a TBI each year • 30% and 65% of people with TBI suffer from some form of dizziness and/or have balance problems at some point during their recovery • 28% of individuals with head trauma have BPPV • A smaller study, of 69 patients with chronic BPPV, found a history of head or neck trauma in 81% of the cohort Pisani et al, 2015 Iglebekk W, 2017 Definitions • Vertigo • Disequilibrium • Presyncope • Floating or rocking sensation • Light headedness ?? DIZZY?? 4 Anatomy and Physiology • 3 Components – Peripheral sensory Apparatus • Motion sensors – Central processor • Vestibular nuclear complex and Cerebellum – Motor output • To ocular muscles and spinal cord Central Sensory Input Motor Output Processor 5 Peripheral Sensory Apparatus [ Motion Sensors] Three Semicircular Canals Lateral, Anterior (superior) and posterior Two Otolith Organs Utricle Saccule 6 • Lateral Canal: Angled at 30°
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Open access Protocol BMJ Open: first published as 10.1136/bmjopen-2020-046510 on 18 March 2021. Downloaded from Epley manoeuvre for posterior semicircular canal benign paroxysmal positional vertigo in people with multiple sclerosis: protocol of a randomised controlled trial Cristina García- Muñoz ,1 María- Dolores Cortés- Vega ,1 Juan Carlos Hernández- Rodríguez ,2 Rocio Palomo- Carrión,3 Rocío Martín- Valero ,4 María Jesús Casuso- Holgado 1 To cite: García- Muñoz C, ABSTRACT Strengths and limitations of this study Cortés- Vega M- D, Hernández- Introduction Vestibular disorders in multiple sclerosis (MS) Rodríguez JC, et al. Epley could have central or peripheral origin. Although the central ► This randomised controlled trial will be the first to manoeuvre for posterior aetiology is the most expected in MS, peripheral damage is semicircular canal benign address knowledge gap on the effectiveness of the also significant in this disease. The most prevalent effect of paroxysmal positional vertigo in Epley manoeuvre in a multiple sclerosis population. vestibular peripheral damage is benign paroxysmal positional people with multiple sclerosis: ► Double- blind and concealed allocation will reduce vertigo (BPPV). Impairments of the posterior semicircular protocol of a randomised the possibility of bias. controlled trial. canals represent 60%–90% of cases of BPPV. The standard BMJ Open ► Videonystagmography goggles will enable the pri- gold treatment for this syndrome is the Epley manoeuvre (EM), 2021;11:e046510. doi:10.1136/ mary outcome of the research to be measured more bmjopen-2020-046510 the effectiveness of which has been poorly studied in patients objectively. with MS. Only one retrospective research study and a case ► Prepublication history and ► The Epley manoeuvre is an easy and quick vestib- study have reported encouraging results for EM with regard additional material for this ular treatment that results in significant changes in to resolution of posterior semicircular canal BPPV.
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Balance Disorders in Children Margaretha L
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