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Abstract Details

Benign Paroxysmal Positional Vertigo: The “SemontPLUS Maneuver” is more effective than the Epley Maneuver – a Prospective Tri-national Randomized Single-Blinded Trial in 195 Patients
Neuro-ophthalmology/Neuro-otology
S12 - Neuro-ophthalmology/Neuro-otology (11:39 AM-11:51 AM)
003

In a previous study we demonstrated that the SM+ is superior to the regular SM. Since other studies showed that the regular SM and the Epley maneuver (EM) are equally effective, we hypothezised that the SM+ is more effective than the EM for the treatment of the posterior canal BPPV canalithiasis. 

To compare the efficacy of the new SemontPLUS maneuver (SM+) with the Epley maneuver (EM) in patients with posterior canal benign paroxysmal positional vertigo (pc-BPPV canalithiasis).

In a prospective multinational (Germany, Italy, Belgium) randomized treatment trial, patients with proven posterior canal BPPV canalithiasis – according to the diagnostic criteria of the International Classification of Vestibular Disorders – were randomly assigned (1:1) to  “SM+” or EM. The SM+ is characterized by an overextension of the head/body by at least 60° below earth horizontal line during step 2 of the maneuver. The first three maneuvers were performed by the physician. The patients were then instructed on how to do the self-maneuvers which they perform three times in the morning, three times at noon and three times at night.  Each morning after the first maneuver of each day the patient documented in a standardized evaluation sheet whether vertigo occurred. The primary endpoint was: “How long (in days) does it take until no attacks can be induced “in the morning” by the maneuvers?”

195 patients were finally analyzed. For the EM it took a mean of 3.34 days (SD 3.6) and a median 1 day for recovery. F or the SM+ it took a mean of 1.96 days (SD 1.6) and a median 1 day for recovery. Statistical analysis with the two-sided Mann-Whitney-u-test revealed a P value of 0.012.

This prospective tri-national randomized trial shows that the SM+ maneuver is superior to the EM in terms of the time it takes until recovery.

Authors/Disclosures
Michael Strupp, MD, DO, FAAN (Hospital of the Ludwig Maximilians University, Munich, Dept of Neurology)
PRESENTER
Dr. Strupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vertify. Dr. Strupp has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for IntraBio. Dr. Strupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vifor, Frisenius, CH. Dr. Strupp has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Strupp has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers. Dr. Strupp has stock in IntraBio.
Anne-Sophie Vinck (Dr. Anne-Sophie Vinck NKO) Dr. Vinck has nothing to disclose.
Otmar Bayer No disclosure on file
Nicolina Goldschagg, MD (Ludwig Maximilians University) Dr. Goldschagg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IntraBio.
Johannes Gerb, MD Mr. Gerb has nothing to disclose.
Vergil Mavrodiev, MD Mr. Mavrodiev has nothing to disclose.
Marco Mandala Marco Mandala has nothing to disclose.