Epley and Semont maneuvers in the treatment of bening paroxymal postural vertigo

To compare the effectiveness of the 'repositioning' Epley maneuver and the 'liberatory' Semont maneuver in the treatment of benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal, a prospective study was performed, with 3 months of followup. A consecutive sample of 100 patients was included in two groups (age-and-sex matched) with a similar number of patients with idiopathic BPPV in each group. Group I was treated using the 'repositioning' maneuver and group II, the 'liberatory' maneuver. At weeks 1, 4, and 12 during the study, the proportion of patients without positional nistagmus was identified, and patients gave an evaluation of their subjective improvement (as a percentage). When positional nystagmus was evident, the corresponding maneuver was used again. Sixty percent of the patients were without nystagmus after the single use of any of the maneuvers. At the end of the study, more than 90% of patients were without nystagmus, with a 90% median value of subjective improvement. Patients with idiopathic BPPV showed a similar response to treatment as patients with BPPV associated to other disorders. We conclude that both maneuvers are effective for the treatment of BPPV of the posterior semicircular canal.