Rapid Systematic Review of the Epley Maneuver for Treating Posterior Canal Benign Paroxysmal Positional Vertigo

Jeroen G van Duijn, Liz M Isfordink, Jenny A Nij Bijvank, Carlijne W Stapper, Annelies J van Vuren, Inge Wegner, Marlous F Kortekaas, Wilko Grolman

Research output: Contribution to journalReview articleAcademicpeer-review


OBJECTIVE: The aim of this study was to compare watchful waiting to the Epley maneuver as a management option for patients with posterior canal benign paroxysmal positional vertigo (p-BPPV) regarding symptom relief.

DATA SOURCES: PubMed, Embase, and The Cochrane Library.

METHODS: A systematic search was conducted. Studies reporting original study data were included. Relevance and risk of bias (RoB) of the selected articles were assessed. Studies with low relevance, high RoB, or both were excluded. Absolute risk differences and their 95% confidence intervals (CIs) were extracted for the included studies.

RESULTS: A total of 1448 unique studies were retrieved. Eight of these satisfied the eligibility criteria. At 1-week follow-up, all included studies reported a clinically relevant effect in favor of the Epley maneuver regarding symptom relief (absolute risk differences ranging from 20% [95% CI, 5%-37%] to 59% [95% CI, 32%-76%]) or conversion to a negative Dix-Hallpike (absolute risk differences ranging from 17% [95% CI, -5%-37%] to 64% [95% CI, 29%-79%]). At 1-month follow-up, the results of the included studies diverged further. Absolute risk differences ranged from 6% (95% CI, -24%-35%) more symptom relief in favor of watchful waiting to 79% (95% CI, 56%-88%) in favor of the Epley maneuver.

CONCLUSION AND RECOMMENDATIONS: All data of the selected studies show a benefit in favor of the Epley maneuver at 1-week follow-up in the management of p-BPPV. The Epley maneuver should be considered in all patients with p-BPPV.

Original languageEnglish
Pages (from-to)925-32
Number of pages8
JournalOtolaryngology and Head and Neck Surgery
Issue number6
Publication statusPublished - Jun 2014
Externally publishedYes

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