A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department
| العنوان: | A comparative study of two methods for treatment of benign paroxysmal positional vertigo in the emergency department |
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| المؤلفون: | Darío Andrés Yacovino, D. Giardino, M. Musazzi, M. Cherchi, M. Perez Akly |
| المصدر: | Journal of Otology Journal of Otology, Vol 16, Iss 4, Pp 231-236 (2021) |
| بيانات النشر: | Elsevier BV, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 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 |
| الوصف: | 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. |
| تدمد: | 1672-2930 |
| DOI: | 10.1016/j.joto.2021.04.002 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dd754faa9f027fea8c61b687193cc372 https://doi.org/10.1016/j.joto.2021.04.002 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....dd754faa9f027fea8c61b687193cc372 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16722930 |
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| DOI: | 10.1016/j.joto.2021.04.002 |