Self-treatment of benign paroxysmal positional vertigo

Radtke, A.; Brevern, Michael von; Tiel-Wilck, Klaus; Mainz-Perchalla, A.; Neuhauser, Hannelore; Lempert, Thomas

doi:10.1212/01.wnl.0000130250.62842.c9

Cited by 115 publications

(85 citation statements)

References 15 publications

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“…So, if the 180° swing is performed quickly enough, then the effect on the posterior canal can be equivalent to a slow backward rotation. The success of the Semont manoeuvre therapy for BPPV is known to depend critically on the speed of the 180° whole-body swing [Radtke et al, 2004]. Analyses of the accelerations acting on the SCC during the Semont manoeuvre suggest that the optimum duration of the 180° swing is less than 1.5 s. The angular velocity in the plane of the target canal during particle repositioning manoeuvres may also affect particle movement [Furuya et al, 2002].…”

Section: Discussionmentioning

confidence: 99%

Head Accelerations during Particle Repositioning Manoeuvres

Faldon

Bronstein

2008

Audiol Neurotol

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Benign paroxysmal positional vertigo (BPPV) due to canalithiasis can be treated with particle repositioning manoeuvres, which aim to evacuate trapped particles from the semicircular canals (SCC). The movement of particles within the SCC is affected by gravity as well as by the accelerations of the head during the manoeuvres. Moreover, as experienced by the particles, gravity is indistinguishable from an upward acceleration of the SCC in free space. We used a set of three orthogonal linear accelerometers to measure the net three-dimensional linear acceleration vector acting on the head during the Hallpike manoeuvre and Epley and Semont particle repositioning manoeuvres (which are used to treat posterior canal BPPV). The projection of the net acceleration vector onto the SCC planes showed that both the Epley and Semont manoeuvres approximated to stepwise, 360°, backward rotations in the plane of the targeted posterior canal. Angular velocity measurements however showed that the rotational component during the central stages of these two manoeuvres is opposite in direction. A simple model of head rotations during particle repositioning manoeuvres was created which showed good agreement to the linear acceleration measurements. Analysis of modelled and measured data identified that speed of movement during the Semont manoeuvre should be critical to its clinical success.

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Section: Discussionmentioning

confidence: 99%

Head Accelerations during Particle Repositioning Manoeuvres

Faldon

Bronstein

2008

Audiol Neurotol

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“…Prior research has demonstrated that patients can self-treat BPPV, although this was tested after patients were provided with illustrations and in-person instructions by an expert. [13][14][15] Effective videos could also be used by providers either as the primary prescription for patients with BPPV or as a reference to patients experiencing a recurrence. 13,14,16 Videos could also serve as a reminder to providers about the maneuver at the time of a patient encounter.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15] Effective videos could also be used by providers either as the primary prescription for patients with BPPV or as a reference to patients experiencing a recurrence. 13,14,16 Videos could also serve as a reminder to providers about the maneuver at the time of a patient encounter. 17 This could be accomplished, for example, by including the videos in the electronic medical record.…”

Section: Discussionmentioning

confidence: 99%

A prescription for the Epley maneuver: www.youtube.com?

Kerber¹,

Burke²,

Skolarus³

et al. 2012

Neurology

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Objectives: Video-sharing Web sites are being used for information about common conditions including dizziness. The Epley maneuver (EM) is a simple and effective treatment for benign paroxysmal positional vertigo (BPPV) of the posterior canal. However, the maneuver is underused in routine care. In this study, we aimed to describe and analyze the available information about the EM on youtube.com. Methods:A YouTube search was performed on August 31, 2011, for videos that demonstrated the entire EM. Detailed data were abstracted from each video and corresponding Web site. Videos were rated on the accuracy of the maneuver by 2 authors, with differences resolved by adjudication. Comments posted by viewers were assessed for themes regarding video use.Results: Of the 3,319 videos identified, 33 demonstrated the EM. The total number of hits for all videos was 2,755,607. The video with the most hits (802,471) was produced by the American Academy of Neurology. Five of the videos accounted for 85% of all the hits. The maneuver demonstration was rated as accurate in 64% (21) of the videos. Themes derived from the 424 posted comments included patients self-treating with the maneuver after reviewing the videos, and providers using the videos as a prescribed treatment or for educational purposes. Conclusion: Accurate video demonstration of the Epley maneuver is available and widely viewedon YouTube. Video-sharing media may be an important way to disseminate effective interventions such as the EM. The impact of video Web sites on outcomes and costs of care is not known and warrants future study. Neurology Benign paroxysmal positional vertigo (BPPV) is caused by freely moving particles (i.e., canaliths) trapped in a semicircular canal of the inner ear.1 The Epley maneuver (EM) (i.e., the canalith repositioning maneuver) is a highly effective treatment supported by 2 evidence-based guidelines.2,3 The maneuver is simple and performed at the bedside in a matter of minutes using a series of positions designed to move the particles out of the canal. However, the EM is substantially underused in routine clinical care.

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“…1 The Epley particle repositioning maneuver (PRM) has proven to be a fast, safe, and effective treatment for BPPV. 2,3 However, studies show that treatment success was only 34% after a single treatment when administered by family physicians, compared with the 67-89% success when administered by specialists. 2,4 The purpose of our study was to determine whether the use of an iPhone application that assists the user in the performance of the PRM had any significant impact on the overall correctness of the performed PRM.…”

Section: Tions Otolaryngologymentioning

confidence: 99%

An iPhone-Assisted Particle Repositioning Maneuver for Benign Paroxysmal Positional Vertigo (BPPV): A Prospective Randomized Study

Organ

Líu

Bromwich

2015

The Journal of the American Board of Family Medicine

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Purpose: The Epley particle repositioning maneuver (PRM) is an effective treatment for benign paroxysmal positional vertigo (BPPV), the most common cause of peripheral vertigo in primary care settings. The goal of this study was to determine whether the use of an iPhone application (DizzyFIX; Clearwater Clinical Ltd, Ottawa, Ontario, Canada) by medical students had a significant impact on the performance of the PRM.Methods: We recruited senior medical students who had previously been trained in the management of BPPV and asked them to perform the PRM on a healthy volunteer. One half of the students used a real iPhone application, whereas the others used a sham application. The PRM performance scores of the 2 groups were compared.Results: iPhone application users scored significantly higher on their PRM performance compared with controls (P < .0001) and performed the PRM significantly more slowly (P < .0001).Conclusions: Senior medical students performed a more correct PRM when assisted by the iPhone application. This application represents a significant improvement from standard medical school training using written instructions. Family physicians could also use this iPhone application for the quick and effective treatment of BPPV. ( J Am Board Fam Med 2015;28:118 -120.)

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Self-treatment of benign paroxysmal positional vertigo

Cited by 115 publications

References 15 publications

Head Accelerations during Particle Repositioning Manoeuvres

Head Accelerations during Particle Repositioning Manoeuvres

A prescription for the Epley maneuver: www.youtube.com?

An iPhone-Assisted Particle Repositioning Maneuver for Benign Paroxysmal Positional Vertigo (BPPV): A Prospective Randomized Study

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