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Self-treatment of BPPV: Semont vs Epley maneuver

On Health & Drugs & Medications » Ear & Nose,Throat

7,023 words with 8 Comments; publish: Sat, 15 Dec 2007 06:22:00 GMT; (90061.52, « »)

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

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 Charit 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 Epleys 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 Epleys 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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  • 8 Comments
    • 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

      #1; Sun, 16 Dec 2007 20:01:00 GMT
    • 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

      Scott

      Hi Scott

      Went and got the article + the video--looked at them both--very interesting--and quite helpful

      --one of the most interesting points(in addition to the success rate) made by the study--was that even for those that did the "modified epley" wrong--it still work for them--however that was not the case for for those who did the modified Semont wrong

      --for those of us with BPPV--it's a "keeper"

      Another good research job!!!

      Tks

      :cool:

      #2; Sun, 16 Dec 2007 20:02:00 GMT
    • 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

      #3; Sun, 16 Dec 2007 20:03:00 GMT
    • 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.
      #4; Sun, 16 Dec 2007 20:04:00 GMT
    • 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

      Hi Scott

      ...."sorts of movements would be beneficial for people without BPPV as a type of VRT"...

      Well with this junk--who knows for sure--but would not think so.

      :cool:

      #5; Sun, 16 Dec 2007 20:05:00 GMT
    • 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

      #6; Sun, 16 Dec 2007 20:06:00 GMT
    • Hi All,

      Here's the link for downloading the two mpeg movies which shows the "modified" maneuvers:

      (Preapproved by moderator1)

      http://www.neurology.org/cgi/content/full/63/1/150/DC1

      Best...Scott :cool:

      #7; Sun, 16 Dec 2007 20:07:00 GMT
    • 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.

      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

      #8; Sun, 16 Dec 2007 20:08:00 GMT