[The effectiveness of the Epley maneuver for the treatment of BPPV and the role of nystagmus direction as an early indicator of successful treatment].

Objectives: We investigated the role of the direction of nystagmus that might occur during the Epley maneuver as an early indicator for treatment success in benign paroxysmal positional vertigo (BPPV).

Patients And Methods: The study included 47 patients (24 males, 23 females; mean age 46+/-12 years; range 29 to 70 years) who underwent the Epley maneuver for BPPV. The occurrence and the direction of nystagmus were observed.

Results: Nystagmus occurred in 16 patients during the maneuver, being ipsilateral in nine patients and contralateral in seven patients. The treatment was successful in seven patients (77.8%) with ipsilateral nystagmus, whereas none of the patients with contralateral nystagmus benefited from the maneuver. While there was no significant relationship between ipsilateral nystagmus and the success of the treatment (p=0.625), a significant correlation was found between contralateral nystagmus and treatment failure (p=0.000).

Conclusion: The occurrence of contralateral nystagmus during the Epley maneuver may be a sign of an unsuccessful result.