A randomized clinical trial to assess the efficacy of the Epley maneuver in the treatment of acute benign positional vertigo

Acad Emerg Med. 2004 Sep;11(9):918-24. doi: 10.1197/j.aem.2004.06.001.


Objectives: To compare the efficacy of the Epley maneuver with that of a placebo maneuver in patients presenting to the emergency department (ED) with benign positional vertigo (BPV).

Methods: This was a prospective, randomized, single-blind placebo-controlled trial. Consecutive adult ED patients presenting to a university teaching hospital with BPV were randomized to treatment with either the Epley or placebo maneuver. The severity of vertigo was evaluated on a 0 to 10-point scale before and after the maneuvers.

Results: Eleven patients were randomized to the Epley group and 11 to the placebo group before the trial was terminated, based on a planned interim analysis. The median decreases in vertigo severity were 6 (95% confidence interval [95% CI] = 4 to 9) for the Epley group and 1 (95% CI = 0 to 3) for the placebo group (p = 0.001).

Conclusions: The Epley maneuver is a simple bedside maneuver that appears to be more efficacious than a placebo maneuver in the treatment of acute BPV among ED patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Emergency Service, Hospital
  • Female
  • Histamine H1 Antagonists / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Posture
  • Promethazine / therapeutic use
  • Severity of Illness Index
  • Single-Blind Method
  • Treatment Outcome
  • Vertigo / classification
  • Vertigo / etiology
  • Vertigo / therapy*


  • Histamine H1 Antagonists
  • Promethazine