A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department
| Autor: | Darío Andrés Yacovino, D. Giardino, M. Musazzi, M. Cherchi, M. Perez Akly |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Benign paroxysmal positional vertigo
medicine.medical_treatment Physical examination Context (language use) Epley maneuver Positional Nystagmus 03 medical and health sciences 0302 clinical medicine Vertigo medicine 030223 otorhinolaryngology Pandemic medicine.diagnostic_test biology Emergency department business.industry Significant difference medicine.disease biology.organism_classification RF1-547 Otorhinolaryngology Anesthesia business 030217 neurology & neurosurgery Research Article |
| Zdroj: | Journal of Otology Journal of Otology, Vol 16, Iss 4, Pp 231-236 (2021) |
| ISSN: | 1672-2930 |
| DOI: | 10.1016/j.joto.2021.04.002 |
| Popis: | Introduction Posterior canal benign paroxysmal positional vertigo (PC-BPPV) is considered the most common 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 has been poorly studied. Objective To compare two protocols of the Epley maneuver for the treatment of PC-BPPV. Patients and methods We prospectively recruited 101 patients with unilateral PC-BPPV on physical examination, randomizing them to either a single Epley maneuver (EM) (n = 46) or multiple maneuvers (n = 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. The DHI 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 EM group and 44.4% in the multiple EM group (p = 0.62). The DHI showed reduction from 42.2 (SD 18.4) to 31.9 (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 = 0.06). A higher number of patients improved from moderate-severe to mild DHI (p = 0.03) in the single EM group compared to the multi-EM group (p = 0.23). Conclusion There was no statistically significant difference between performing a single EM versus multiple EMs for treatment of PC-BPPV in the emergency department. The single EM approach is associated with shorter physical contact between patients and examiner, which is logically safer in a pandemic context. |
| Databáze: | OpenAIRE |
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