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Old 08-01-2004, 03:31 AM   #1
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Self-treatment of BPPV: Semont vs Epley maneuver

Hi Folks,

I came across this article which discusses findings in the journal Neurology which reports the highly successful *self-treatment* of BPPV in a group of sufferers. Useful to know that the Epley seems to be the best treatment for those of you dealing with BPPV:

Neurology, Jul 13 2004, 63(1) p150-152

Quote:
People with vertigo can get relief by doing maneuvers at home, according to a study published in the July 13 issue of Neurology, the scientific journal of the American Academy of Neurology.

"For most people, one treatment is all it takes to stop the vertigo,” said study author Andrea Radtke, MD, a neurologist with Charité Campus Virchow Clinic in Berlin, Germany. “But some people need repeated treatments before it resolves completely. For these people, it would be beneficial to have the option to treat themselves at home.”

The study involved 70 people who had experienced vertigo for an average of eight weeks. The study tested two different maneuvers. Both of the maneuvers involve head and body movements performed while sitting on a bed. Half of the people performed one maneuver and half performed the other. They received instructions for the maneuver and performed it once with the doctor. Then they performed the exercise three times a day at home until the vertigo had stopped for at least 24 hours.

After one week, 95 percent of those who performed the maneuver called the modified Epley’s procedure had no more symptoms. Of those performing the modified Semont maneuver, 58 percent had no more symptoms.

A video showing the maneuvers is available on the Neurology journal website.

The researchers recommend the modified Epley’s procedure for people who do not get relief after a first treatment by a doctor or therapist or for people whose vertigo recurs frequently.
Scott

 
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Old 08-01-2004, 03:17 PM   #2
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Re: Self-treatment of BPPV: Semont vs Epley maneuver

Hi,

I had 100% success with the Semont with the right ear. But, not with the left ear.

I think it depends on if there's a primary disorder/cause (viral) for the BPPV (secondary) to begin with which I suspect was what I had in the left ear. It was a ride with both at the same time to be sure!

Whatever the stats....it doesn't mean that either couldn't work for anyone....and trying them at home is well worth doing rather than suffering while waiting for an appointment.

I'm curious about the word modified -- that could definitely have an impact on the outcome.

quincy
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Old 08-02-2004, 01:47 AM   #3
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Re: Self-treatment of BPPV: Semont vs Epley maneuver

Quincy - interesting how the Semont worked well for you and your note on whether the BPPV was primary or secondary. Did you ever try the Epley? Are you now at 100%?

Subs - just had a look at the videos myself. The second one is definitely a new series of movements I hadn't seen before. I'm just waiting for approval from mod1 to post the link so others can get to it quickly. I wonder if these sorts of movements would be beneficial for people without BPPV as a type of VRT or would it be the wrong thing to do?

Cheers....Scott

 
Old 08-02-2004, 02:21 AM   #4
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Re: Self-treatment of BPPV: Semont vs Epley maneuver

Ive got a secondary problem of BPPV. I had another attack 2 weeks ago and self-treated as I was taught the modified epley. It definately helped. By the time I made it to the appointment there was only a few crystals still floating about. Self treatment is definately worth a try while waiting for the specialist.

 
Old 08-02-2004, 03:41 PM   #5
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Re: Self-treatment of BPPV: Semont vs Epley maneuver

Hi Scott,

Thanks for that. I actually saw an abstracted portion of that article in the New York Times about 1-1/2 weeks ago. I had the Epley and it worked great for me, as you know. My ENT who performed the Epley also encouraged me to do it at home if I needed to, but luckily I haven't had to.

T

 
Old 08-29-2004, 03:37 AM   #6
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Re: Self-treatment of BPPV: Semont vs Epley maneuver

Just wanted to add a little more info here that I chased up on the first paper posted on the MEP back in 1999 (Neurology 53(6):1358-1360):

A modified Epley's procedure for self-treatment of benign paroxysmal positional vertigo - A Radtke et al.

In the first trial, they compared the MEP and Brandt-Daroff exercises (BDE) for self-treatment of BPPV in 54 patients. BPPV resolved within 1 week in 18 of 28 patients (64%) using the MEP and in 6 of 26 patients (23%) performing BDE (p < 0.01). Type and adequate performance of the maneuver predicted treatment outcome in the analysis. The frequency of side effects was not significantly different between the two groups.

Quote:
Instruction for the modified Epley's procedure (for BPPV of the posterior semicircular canal of the right ear). (1) Start by sitting on a bed and turn your head 45° to the right. Place a pillow behind you so that on lying back it will be under your shoulders. (2) Lie back quickly with shoulders on the pillow, neck extended, and head resting on the bed. In this position, the affected (right) ear is underneath. Wait for 30 seconds. (3) Turn your head 90° to the left (without raising it) and wait again for 30 seconds. (4) Turn your body and head another 90° to the left and wait for another 30 seconds. (5) Sit up on the left side. This maneuver should be performed three times a day. Repeat this daily until you are free from positional vertigo for 24 hours.
Scott

 
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