Nineteen patients (19.6%) in the EM group and 24 (24.5%) in the SM-plus group experienced relevant nausea.Ĭonclusions and Relevance The SM-plus self-maneuver is superior to the EM self-maneuver in terms of the number of days until recovery in pcBPPV. The exercises are usually repeated several times under the supervision of a doctor. No serious adverse event was detected with both maneuvers. The Epley maneuver and the Semont maneuver are two very simple and effective repositioning procedures for the treatment of BPPV that is caused by crystals in the posterior semicircular canal. For the secondary end point (effect of a single maneuver), no significant difference was detected (67 of 98 vs 61 of 97 P = .42 α = .05). The mean (SD) time until no positional vertigo attacks could be induced in the SM-plus group was 2.0 (1.6) days (median, 1 day 95% CI, 1.64-2.28 days) in the EM group, 3.3 (3.6) days (median, 2 days 95% CI, 2.62-4.06 days) ( P = .01 α = .05, 2-tailed Mann-Whitney test). Results Of the 195 participants included in the analysis, the mean (SD) age was 62.6 (13.9) years, and 125 (64.1%) were women. The secondary end point was the effect of the single maneuver performed by the physician. The primary end point was the number of days until no positional vertigo could be induced on 3 consecutive mornings. Main Outcome and Measures Patients had to document whether they could provoke positional vertigo every morning. Interventions After being randomized to the SM-plus or the EM group, patients received 1 initial maneuver from a physician, then subsequently performed self-maneuvers at home 3 times in the morning, 3 times at noon, and 3 times in the evening. The analysis was prespecified and per-protocol. Home remedies for vertigo include the Epley maneuver, acupressure, staying hydrated, vitamin D supplements, and ginger tea. After consideration of the exclusion criteria as well as informed consent, 56 patients were excluded and 2 declined to participate, with 195 participants included in the final analysis. Two hundred fifty-three patients were assessed for eligibility. Patients were selected randomly during routine outpatient care after being referred to 1 of the 3 centers. Recruitment took place from June 1, 2020, until March 10, 2022. Objective To compare the effectiveness of the Semont-plus maneuver (SM-plus) and the Epley maneuver (EM) for treatment of posterior canal benign paroxysmal positional vertigo (pcBPPV) canalolithiasis.ĭesign, Setting, and Participants This prospective randomized clinical trial was performed at 3 national referral centers (in Munich, Germany Siena, Italy and Bruges, Belgium) over 2 years, with a follow-up to 4 weeks after the initial examination. Importance Questions remain concerning treatment efficacy for the common condition of benign paroxysmal positional vertigo (BPPV).
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