A Comparative Study to Assess the Effectiveness of Epley’s Maneuver Vs Brandt Daroffs Home Exercises for Management of Benign Paroxysmal Positional Vertigo
Background- Vertigo is one of the most distressing symptom seen in patients encountered in clinical practice by otolaryngologist and neurologist. It results from dysfunction of vestibular system, among which most common is BBPV(benign paroxysmal positional vertigo). BPPV present with short episodes of vertigo lasting for few seconds, usually precipitated by change in head position. In BPPV, otoconia from utricles are thought to collect in semicircular canal making them abnormally gravity sensitive. BPPV is clinical diagnosis on the basis of typical history and Dix Hallpike testing. Dr. T Brandt and Daroff introduced Brandt daroff home exercises based on cupulolithiasis theory.In 1980, John M Epley introduced canalolith repositioning procedure of Epley in the treatment of BPPV. Because of lack of consensus regarding the optimal treatment maneuver, in our study we have compared the effectiveness of Brandt Daroff and Epleys maneuver. Aim- To compare the effectiveness of Epley’s maneuver and Brand-Daroff home exercises for treatment of benign positional paroxysmal vertigo at tertiary care hospital. Materials and methods- A prospective interventional and comparative study was conducted. A total of 240 patients complaining of giddiness were evaluated in this format out of which 68 patients were diagnosed to have BPPV. Due to Covid-19 pandemic there was loss of follow up to some patients. Remaining 54 patients were enrolled in the study and divided into 2 groups group 1 and group 2 by chit allocation. Group 1 Received Epley’s maneuver and Group 2 Brandt- Daroff home exercises was given. The outcome of 2 groups compared with Dixhallpikes test and DHI (dizziness handicap inventory )questionare Conclusion- In the treatment of BPPV, Brandt-Daroff vestibular exercises are as effective as Epley canalolith repositioning maneuvers with a similar mean Dizziness Handicap Inventory (DHI) Score between the groups. Hence, according to patient’s circumstances both treatments may be utilized.
