A Prospective Observational Study on the Efficacy of Epley’s Maneuver versus Universal Repositioning Maneuver in Managing Benign Paroxysmal Positional Vertigo

Introduction: The most prevalent cause of peripheral vertigo is Benign paroxysmal positional vertigo (BPPV), which results from the displacement of free-floating otoconia within the semicircular canals. This displacement induces transient episodes of vertigo and nystagmus. This study evaluates and compares the efficacy of the Epley and Universal repositioning maneuvers in managing BPPV arising due to posterior semicircular canal pathlogy. Outcome measures were the reduction of nystagmus intensity, tolerability of induced dizziness, balance, and long-term efficacy. Patients and Methods: A prospective clinical study was conducted over a 2-year period at a tertiary hospital in Abu Dhabi, UAE, involving 100 patients. Fifty patients were randomly assigned to undergo either the Epley or Universal repositioning maneuver. Follow-up evaluations were performed at 1 week, 1 month, and 3 months, to assess treatment outcomes. Results: In a study assessing the efficacy of the Epley and Universal repositioning maneuvers in BPPV patients, 87 out of 100 showed symptomatic relief, including reduced dizziness intensity, nystagmus, and nausea, along with improved balance. Specifically, 88% (44 out of 50 patients) of those in the Epley group and 76% (38 out of 50 patients) in the universal repositioning group exhibited significant posttherapy improvement, although balance issues persisted in the latter. Follow-up assessments at 1 week, 1 month, and 3 months indicated ongoing improvement in both groups. However, by 3-month follow-up, 20 patients in the universal repositioning group reported recurrence, suggesting a higher relapse rate. Two patients in the Epley maneuver and 4 patients in the universal repositioning maneuver lost to follow-up. Conclusion: The Epley maneuver was significantly more efficacious in reducing nystagmus intensity tolerability, balance, and nausea and appears to offer more sustained symptom relief with less recurrence compared to the universal repositioning maneuver. However, statistically, there was no significant difference between the two procedures.