Comparison Of The Efficacy Of The Modified Epley Maneuver And Evoked Postural Exercises For Benign Paroxysmal Positional Vertigo

Objective: Comparison of the efficacy of the modified Epley maneuver and evokedpostural exercises for Benign Paroxysmal Positional vertigo(BPPV) in the prospectivecohort studyMethods: During the period from2012October to2014February in Department ofinternal medicine in Second Affiliated Hospital of Fujian Medical College, the120outpatient and hospitalized patients with neurological with benign paroxysmalpositional vertigo were divided into three groups in accordance with the principle ofrandom.The three groups are treated with modified Epley maneuver、treated withevoked postural exercises after the modified Epley maneuver and only treated withevoked postural exercises.Treated the three groups with different treatment, clinicalobservation. Diagnosis is based on Positioning maneuver, and classification accordingto the head and nystagmus induced direction.Results: Lesion was located in the posterior semicircular canal-BPPV in103patients(semicircular canal-canalithiasis93cases, semicircular canal-cupulolithiasis10cases),horizontal semicircular canal in17patients(semicircular canal-canalithiasis15cases, semicircular canal-cupulolithiasis2cases),and without superior semicircularcanal-canalithiasis patient. Of the120patients,33were male and87female, with amean age of57±2.82years old.The latency period of nystagmus of posterior canalswas (4.67±2.68) s, and time of persistence was (10.75±6.5)s. The latency period ofnystagmus of horizontal canals was (5.32±3.33)s, and the time of persistence was(10±5.86)s. There were insignificant differences in the latency period of nystagmusand time of persistence between the vertical and horizontal canals (P=0.199和P=0.147).The initial success rate was82.5%for all40patients treated with the modifiedEpley maneuver；80%for for all40patients treated with the modified Epley maneuver+evoked postural exercises;35%for for all40patients treated with theevoked postural exercises; At one week following up, the success rate of3groupswere92.5%,92.5%,90%.At three months following up, the success rate of3groups were97.5%,100%,100%.Conclusion: The early cure rate of maneuver may be more effective than evokedpostural exercises to treat benign paroxysmal positional vertigo, but there was nosignificant difference between two treatments after three months and the long-termrecurrence rate lower.