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Objective

To evaluate the long-term efficacy of the Epley manoeuvre as a therapeutic procedure for posterior canal benign paroxysmal positional vertigo.

Design

Randomised, double-blind, sham-controlled trial.

Setting

A multidisciplinary dizziness unit in a non-academic Hospital.

Participants

Forty-four patients with posterior canal benign paroxysmal positional vertigo (BPPV) with a duration of at least 1 month. Participants were randomised in two groups of 22 and treated with either the Epley manoeuvre or a sham manoeuvre and followed up for 1 year after treatment.

Main outcome measures

Conversion of a ‘positive’ Dix–Hallpike test to a ‘negative’ Dix–Hallpike test, impairments perceived by the dizziness assessed by the Dizziness Handicap Inventory (DHI).

Statistical analysis

Absolute and relative risks were computed, and Fisher's exact test was used to compare the treatments.

Results

Six patients were lost to follow up (five in the sham group, one in the Epley group). The Epley procedure resulted in a treatment success in 20/22 patients (91%) after 12 months of follow-up, whereas the sham procedure had a positive effect in 10/22 patients (46%; P = 0.001). The DHI was significantly lower in the Epley group at all follow-up assessments (median scores 12 months 0 (0–51) versus 20 (0–76), P = 0.003).

Conclusion

The Epley manoeuvre provides long-term resolution of symptoms in patients with posterior canal BPPV.