The Epley manoeuvre for benign paroxysmal positional vertigo--a systematic review.

Benign paroxysmal positional vertigo (BPPV) is a syndrome characterized by short-lived episodes of vertigo in association with rapid changes in head position. Current treatment approaches include rehabilitative exercises and physical manoeuvres including the Epley manouevre. Randomized clinical trials of the Epley manoeuvre were identified. Outcome measures that were considered include: frequency and severity of attacks of vertigo; proportion of patients improved by each intervention; and conversion of a 'positive' Dix-Hallpike test to a 'negative' Dix-Hallpike test. Patients who received the Epley manoeuvre were more likely to have complete resolution of their symptoms [odds ratio 4.92 (95% C.I. 1.84-13.16)], and more likely to convert from a positive to negative Dix-Hallpike test [odds ratio 5.67 (95% C.I. 2.21-14.56)]. There were no serious adverse effects of treatment. There is some evidence that the Epley manouevre is a safe effective treatment for posterior canal BPPV.