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Epley maneuver for benign paroxysmal positional vertigo: Evidence synthesis for guidelines for reasonable and appropriate care in the emergency department

Epley maneuver for benign paroxysmal positional vertigo: Evidence synthesis for guidelines for... INTRODUCTIONBenign paroxysmal positional vertigo (BPPV) is a common cause of episodic dizziness, accounting for ~20% of cases of dizziness seen in the emergency department (ED), which corresponds to about 960,000 BPPV cases per year in the United States.1 Episodes are often accompanied by a sensation of intense nausea and vomiting, are triggered by head movement, and usually last 60 s or less.2 The cumulative lifetime incidence of BPPV approaches 10%3 and its incidence increases by approximately 38% per decade of life.4 BPPV is associated with significant reductions in the quality of life and an increased risk of falls.5,6BPPV is usually caused by free‐floating otoliths displaced from the utricle into one of the three semicircular canals of the inner ear, causing continuing movement of the endolymph even after head movement has ceased, thus precipitating dizziness and nystagmus.7 The posterior canal (pc) is the most commonly affected canal, accounting for the majority of patients with BPPV,8,9 leading to pc‐BPPV being the most common variant of BPPV. BPPV is usually idiopathic but in 10% of cases, may occur secondary to trauma, labyrinthitis, or ischemia.3,7 BPPV should be suspected in patients presenting with positional vertigo lasting less than 60 s, termed triggered vestibular syndrome, although http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Academic Emergency Medicine Wiley

Epley maneuver for benign paroxysmal positional vertigo: Evidence synthesis for guidelines for reasonable and appropriate care in the emergency department

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References (95)

Publisher
Wiley
Copyright
Copyright © 2023 Society for Academic Emergency Medicine
ISSN
1069-6563
eISSN
1553-2712
DOI
10.1111/acem.14739
Publisher site
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Abstract

INTRODUCTIONBenign paroxysmal positional vertigo (BPPV) is a common cause of episodic dizziness, accounting for ~20% of cases of dizziness seen in the emergency department (ED), which corresponds to about 960,000 BPPV cases per year in the United States.1 Episodes are often accompanied by a sensation of intense nausea and vomiting, are triggered by head movement, and usually last 60 s or less.2 The cumulative lifetime incidence of BPPV approaches 10%3 and its incidence increases by approximately 38% per decade of life.4 BPPV is associated with significant reductions in the quality of life and an increased risk of falls.5,6BPPV is usually caused by free‐floating otoliths displaced from the utricle into one of the three semicircular canals of the inner ear, causing continuing movement of the endolymph even after head movement has ceased, thus precipitating dizziness and nystagmus.7 The posterior canal (pc) is the most commonly affected canal, accounting for the majority of patients with BPPV,8,9 leading to pc‐BPPV being the most common variant of BPPV. BPPV is usually idiopathic but in 10% of cases, may occur secondary to trauma, labyrinthitis, or ischemia.3,7 BPPV should be suspected in patients presenting with positional vertigo lasting less than 60 s, termed triggered vestibular syndrome, although

Journal

Academic Emergency Medicine – Wiley

Published: May 1, 2023

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