A randomized clinical trial to assess the efficacy of the Epley maneuver in the treatment of acute benign positional vertigo.

OBJECTIVES To compare the efficacy of the Epley maneuver with that of a placebo maneuver in patients presenting to the emergency department (ED) with benign positional vertigo (BPV). METHODS This was a prospective, randomized, single-blind placebo-controlled trial. Consecutive adult ED patients presenting to a university teaching hospital with BPV were randomized to treatment with either the Epley or placebo maneuver. The severity of vertigo was evaluated on a 0 to 10-point scale before and after the maneuvers. RESULTS Eleven patients were randomized to the Epley group and 11 to the placebo group before the trial was terminated, based on a planned interim analysis. The median decreases in vertigo severity were 6 (95% confidence interval [95% CI] = 4 to 9) for the Epley group and 1 (95% CI = 0 to 3) for the placebo group (p = 0.001). CONCLUSIONS The Epley maneuver is a simple bedside maneuver that appears to be more efficacious than a placebo maneuver in the treatment of acute BPV among ED patients.