No abstract

Objective: Recurrence is common in the treatment of Benign Paroxysmal Positional Vertigo (BPPV) with an Epley maneuver. Methods such as manipulation are also effective in treatment. The study was aimed to determine the effect of cervical manipulation added to the Epley maneuver in treatment of patients with BPPV who has cervical lordosis and neck pain. Material and Methods: Patients diagnosed with BPPV who has flattened cervical lordosis with at least level 6 neck pain in VAS and over 18 years of age were included in the study. Patients were stratified into two groups according to age and gender. In the first and control examination one month later, cervical manipulation was performed in addition to Epley maneuver to the first group (combined therapy), and only Epley maneuver to the second group. Patients were examined with video-headimpulse test (VHIT), the severity of neck pain determined with VAS and symptoms were questioned with the vertigo symptom scale (VSS) prior and after treatment. Results: There was no difference between the groups in terms of VAS-pain, VSS and VHIT parameters before treatment (p˃ 0.05). While there was no difference in vestibulo-ocular reflex (VOR) gains between the study groups (p˃ 0.05), there was a significant difference in terms of VSS and VAS-pain (p = 0.01), after treatment. When compared by pathological VHIT findings, there was a significant difference in terms of improvement in favor of the combined treatment group after treatment (p = 0.02). At intragroup comparisons, VSS, VAS-pain, values were significantly decreased after treatment in both groups (p=0.01). While intragroup pathologic VHİT findings were considered before and after treatment, there was no significant difference in improvement after treatment in the Epley group (p˃0.05). Contrarily difference was significant in the combined treatment group (p=0.01). Conclusion: Epley and manipulation therapy are more successful when applied together.