Meta-analysis on the efficacy of Epley's manoeuvre in benign paroxysmal positional vertigo

Introduction: Benign paroxysmal positional vertigo (BPPV) is one of the most common conditions that cause the physiognomy of peripheral vertigo. Objective: To evaluate the effectiveness of Epley's manoeuvre (EM) in the treatment of BPPV using a critical review of the medical literature and a meta-analysis. Methods: Searches were made in the databases of MEDLINE (PubMed), in the Cochrane collection (Cochrane Register of controlled studies), BIREME and LILACS (all of them up to December 2008). The search words used were: canalith repositioning procedure, canalith repositioning manoeuvre, Epley manoeuvre, Dix-Hallpike, benign vertigo, benign positional vertigo, benign paroxysmal positional vertigo and BPPV. The meta-analysis was performed using the program RevMan 5.0. Results: The patients on whom an EM was performed had a six and half times more chance of their clinical symptoms improving compared to the control group of patients (OR = 6.52; 95% CI, 4.17-10.20). Similarly, the likelihood of having a negative Dix-Hallpike (DH) test are 5 times greater in patients had the EM performed than in those who did not (OR = 5.19; 95% CI, 2.41-11,17). Conclusions: The EM is effective in controlling BPPV. (C) 2009 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L. All rights reserved.