I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency of the Epley manoeuvre as a long-term therapeutic procedure for posterior canal benign paroxysmal positional vertigo (BPPV). A randomised, double blind sham-controlled trial involving two groups of 22 patients ensued. Following identification of BPPV, participants were treated with either an Epley or sham procedure and followed up for a year post treatment. Outcome measures of both conversion of a positive Dix Hallpike test to a negative Dix Hallpike test and Dizziness Handicap Inventory were used. Treatment success was found in 91% of patients after 12 months of follow-up in the Epley group as opposed to 46% in the sham group.

A randomised sham-controlled trial to assess the long-term effect of the Epley manoeuvre for treatment of posterior canal benign paroxysmal positional vertigo.
Bruintjes TD, Companjen J, van der Zaag-Loonen HJ, van Benthem PP.
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Andy Hall

FRCS (ORL-HNS), North Thames, ST7 Northwick Park Hospital, London, UK.

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