Epley maneuver for treating dizziness in the emergency department
Evaluating the Efficacy of Epley Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department: A Randomized Controlled Trial.
This trial tests whether doing the Epley maneuver, versus a sham maneuver, helps adults with posterior canal BPPV who come to the emergency department feel less dizzy.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 118 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | American University of Beirut Medical Center Academic / other |
| Drugs / interventions | cyclophosphamide |
| Locations | 1 site (Beirut) |
| Trial ID | NCT07111000 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial enrolls adults presenting to the emergency department with posterior semicircular canal BPPV confirmed by a positive Dix-Hallpike test and randomizes them to either the Epley maneuver or a sham maneuver. Participants complete the Dizziness Handicap Inventory (DHI) at baseline and again three days after enrollment, and report immediate symptom response on a 0–10 Likert scale. The study also records how many participants who consented cannot complete the full Epley maneuver because of severe symptoms. Outcomes compare mean change in DHI scores, immediate Likert responses, and the proportion unable to finish the maneuver between the two arms.
Who should consider this trial
Good fit: Adults over 18 who present to the ED with brief positional vertigo and a positive Dix-Hallpike test indicating posterior canal BPPV and who can give informed consent are ideal candidates.
Not a fit: Patients with contraindications such as severe cervical disease, unstable cardiovascular conditions, signs of vertebrobasilar disease, high-grade carotid stenosis, or other non-BPPV causes of dizziness are unlikely to benefit from the maneuver in this trial.
Why it matters
Potential benefit: If successful, the Epley maneuver could provide faster, medication-free relief for BPPV-related dizziness in the emergency department.
How similar studies have performed: The Epley maneuver is well supported by prior trials for posterior canal BPPV in outpatient settings, though randomized sham-controlled data specifically from emergency department populations are more limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria * Age: above 18 years old * Patients presenting to the ED with symptoms of BPPV (single or recurrent episodes of vertigo lasting up to 2 minutes) and a positive DHT (episode of vertigo associated with torsional upbeating nystagmus) indicating a posterior semicircular canal BPPV. * Patients who are able to understand and provide a signed informed consent to participate in the study Exclusion Criteria * Severe cervical diseases (e.g., soft tissue disorders, cervical spondylosis, prolapsed intervertebral disks and severe rheumatoid arthritis with cervical instability …) * Unstable cardiovascular diseases (e.g., hemodynamically unstable, decompensated heart failure, acute myocardial infarction, decompensated valvular diseases, severe arrhythmias …) * Suspected vertebrobasilar diseases (e.g., cerebellar signs, vision changes, numbness or tingling in the extremities, slurred speech, changes in mental status, confusion …) * History of high-grade carotid stenosis * Recent (\<24 hours) intake of aminoglycosides, chemotherapeutic agents, cyclophosphamide, loop diuretics, or quinines * Patients with peripheral causes of vertigo other than BPPV (such as Meniere's disease or vestibular neuritis) * Patients with central causes of vertigo (vestibular migraine, Arnold Chiari malformation, history of CNS tumor(s), multiple sclerosis) * Patients with focal deficits on neurological exam * Patients with an episode of vertigo lasting more than 2 minutes * Patients with a negative DHT * Patients with pure horizontal or vertical nystagmus * Patients with lateral and anterior semicircular canals BPPV * Participants refusing to undergo Epley maneuver * Pregnancy beyond the 24th week of gestation
Where this trial is running
Beirut
- American University of Beirut — Beirut, Lebanon (Recruiting)
Study contacts
- Study coordinator: Eveline Hitti, MD
- Email: eh16@aub.edu.lb
- Phone: 00961-1-350000
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.