Resolution of severe vertigo in a remote location by the modified Epley maneuver

Khalid Bashir; Tooba Tariq; Furqan B. Irfan; Sameer A. Pathan

doi:10.5339/jemtac.2015.1

ISSN: 1999-7086
EISSN: 1999-7094

oa Resolution of severe vertigo in a remote location by the modified Epley maneuver
Authors: Khalid Bashir¹, Tooba Tariq¹, Furqan B. Irfan¹ and Sameer A. Pathan¹
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Affiliations: ¹ Emergency Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Source: Journal of Emergency Medicine, Trauma and Acute Care, Volume 2015, Issue 1, Feb 2015, 1
DOI: https://doi.org/10.5339/jemtac.2015.1
- Received: 22 June 2014
- Accepted: 11 November 2014
- Published online: 11 February 2015

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Abstract

Benign paroxysmal positional vertigo (BPPV) is an extremely common cause of peripheral vertigo. BPPV is believed to be caused by the presence of tiny crystals in the semicircular canals. It is typically diagnosed from a patient's history and examination.

A 55-year-old lady dialed the emergency services due to severe vertigo and vomiting for about two hours. The previous night she travelled around 250 miles in her caravan to North Wales, UK, for a holiday. No ambulance was available to be dispatched, hence the ambulance control contacted the local general practitioner doctor on duty to attend to the patient. The patient was suffering from recurrent vertigo symptoms for nearly two years, despite being on medications. She described her symptoms as room spinning when she wanted to get out of the bed which was associated with vomiting. History and examination revealed no signs attributing to acute stroke.

After performing the Dix-Hallpike test, the doctor confirmed the diagnosis of posterior canal BPPV and the patient was offered the modified Epley maneuver. Post-maneuver, a significant improvement in her symptoms was noticed within a few minutes. On arrival of ambulance crew after an hour, the patient decided not to go to hospital as her symptoms were almost 90 percent better. This case highlights the need for awareness among family medicine and emergency doctors to diagnose and treat BPPV with a physical maneuver rather than medications.

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References

Li JC, Li CJ, Epley J, Weinberg L. Cost-effective management of benign positional vertigo using canalith repositioning. Otolaryngol Head Neck Surgery. 2000; 122::334–339.
[Google Scholar]
Lee NH, Ban JH, Lee KC, Kim SM. Benign paroxysmal positional vertigo secondary to inner ear disease. Otolaryngol Head Neck Surgery. 2010; 143::413–417.
[Google Scholar]
von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H. Epidemiology of benign paroxysmal positional vertigo: A population based study. J Neurol Neurosurg Psychiatry. 2007; 78::710–715.
[Google Scholar]
Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol. 1952; 61::987–1016.
[Google Scholar]
Hall SF, Ruby RR, McClure JA. The mechanics of benign paroxysmal vertigo. J Otolaryngol. 1979; 8::151–158.
[Google Scholar]
Epley JM. The canalith repositioning procedure: For treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surgery. 1992; 107::399–404.
[Google Scholar]
Epley JM. Human experience with canalith repositioning maneuvers. Ann N Y Acad Sci. 2001; 942::179–191.
[Google Scholar]
Zhang YX, Wu CL, Xiao GR, Zhong FF. [Comparison of three types of self-treatments for posterior canal benign paroxysmal positional vertigo: Modified Epley maneuver, modified Semont maneuver and Brandt-Daroff maneuver]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. Chinese Journal of Otorhinolaryngology Head and Neck Surgery. 2012; 47::799–803.
[Google Scholar]

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Resolution of severe vertigo in a remote location by the modified Epley maneuver

Journal of Emergency Medicine, Trauma and Acute Care 2015, 1 (2015); https://doi.org/10.5339/jemtac.2015.1

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Keyword(s): Benign paroxysmal positional vertigo, Dix-Hallpike maneuver, emergency medicine, Epley maneuver, modified Epley maneuver, vertigo, dizziness and vomiting

oa Resolution of severe vertigo in a remote location by the modified Epley maneuver

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