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Treating Benign Paroxysmal Positional Vertigo (BPPV) in ED Patients

This study has been completed.
Information provided by (Responsible Party):
David Burmeister, Lehigh Valley Hospital Identifier:
First received: February 13, 2008
Last updated: September 7, 2016
Last verified: September 2016
Benign Paroxysmal Positional Vertigo (BPPV) is a common complaint of emergency department patients. The importance of early diagnosis and treatment can lead to a much improved quality of life for patients afflicted by this ailment. It is the purpose of this study to evaluate and examine two methods of treatment. Patients will be randomized to receive the more common conventional medication therapy versus the canalith repositioning technique. All patients enrolled into this study are emergency department patients who have been diagnosed with BPPV via a positive Dix-Hallpike Maneuver. The hypothesis of this study is that vestibular rehabilitation will allow for resolution of symptoms without the use of conventional medication therapy in the acute management of BPPV in the emergency department patient.

Condition Intervention
Benign Paroxysmal Positional Vertigo
Drug: Meclizine
Other: Epley Maneuver
Drug: Lorazepam
Drug: Diphenhydramine
Drug: Ondansetron

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Care Provider)
Primary Purpose: Treatment
Official Title: A Randomized Trial to Evaluate Resolution of Symptoms Using Vestibular Rehab Versus Conventional Therapy in Patients Presenting to the Emergency Department (ED) With Diagnosis of Benign Paroxysmal Positional Vertigo (BPPV)

Resource links provided by NLM:

Further study details as provided by Lehigh Valley Hospital:

Primary Outcome Measures:
  • Likert Scale for improvement [ Time Frame: 0, 3, 7, 30 days ]

Enrollment: 26
Study Start Date: November 2006
Study Completion Date: November 2013
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Arm 1, Conventional Therapy
Patients will receive standard conventional medication therapy (i.e., meclizine, diphenhydramine, lorazepam, ondansetron).
Drug: Meclizine
medication administration 25mg PO one time
Other Name: Antivert
Drug: Lorazepam
Lorazepam 1 - 5mg PO/IV prn
Other Name: Valium
Drug: Diphenhydramine
25 - 50mg PO/IV once prn
Other Name: Benedryl
Drug: Ondansetron
Ondansetron 4 - 8 mg PO/IV prn
Other Name: Zofran
Experimental: Arm 2, Epley Maneuver
Patients will receive vestibular rehabilitation (the Epley Maneuver).
Other: Epley Maneuver
Patient has vestibular rehabilitation utilizing the Epley Maneuver.
Other Name: Canalith Repositioning Technique

  Show Detailed Description


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Subject is a male or female >18 years of age.
  2. Subject has presented to the Emergency Department Monday through Friday during the hours of 8 AM to 4:30 PM or possibly extended into the evening and weekend hours if research or physical therapy staff is available, and is diagnosed with BPPV.
  3. Subject has positive findings of vertigo and nystagmus when the Dix-Hallpike maneuver is performed during physical examination. A Dix-Hallpike maneuver will be considered positive when the patient experiences nystagmus but resolves or fatigues in less than 60 seconds
  4. Informed consent can be obtained for participation in this study.

Exclusion Criteria:

  1. Subject has taken any antihistamines or anticholinergics within the past 12 hours.
  2. Subjects who are unable to ambulate.
  3. Subjects with severe cervical spine disease or known cerebral vascular disease.
  4. Any positive findings during the neurological exam during physical examination.
  5. Subjects who have negative finding of vertigo and nystagmus when the Dix- Hallpike maneuver is performed by the Physical Therapist or research staff even if the subject had a positive finding of vertigo and nystagmus when the Dix-Hallpike maneuver was performed by the physician or resident.
  6. Subjects with a known history of Meniere's Disease.
  7. Any cardiac complaints during physical examination or subject has experienced a positive loss of consciousness.
  8. Subject has been previously enrolled in this study.
  9. Subjects with mental conditions that render them unable to understand the nature,
  10. Subjects who are unlikely to comply with the study such as subjects with uncooperative attitude, unlikely to complete follow-up visits, or unlikely to complete the study.
  11. Any other condition which would confound or interfere with evaluation or prevent compliance with the study protocol.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00641797

United States, Pennsylvania
Lehigh Valley Hospital
Allentown, Pennsylvania, United States, 18103
Sponsors and Collaborators
Lehigh Valley Hospital
Principal Investigator: David B. Burmeister, DO Lehigh Valley Hospital
  More Information

Responsible Party: David Burmeister, Chair, Department of Emergency Medicine, Lehigh Valley Hospital Identifier: NCT00641797     History of Changes
Other Study ID Numbers: 2-2006123IRB#
Study First Received: February 13, 2008
Last Updated: September 7, 2016
Individual Participant Data  
Plan to Share IPD: No
Plan Description: No plan to share IPD, just publish the study's results.

Keywords provided by Lehigh Valley Hospital:
Canalith Repositioning Technique

Additional relevant MeSH terms:
Benign Paroxysmal Positional Vertigo
Vestibular Diseases
Labyrinth Diseases
Ear Diseases
Otorhinolaryngologic Diseases
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Sensation Disorders
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Dermatologic Agents
Serotonin Antagonists
Serotonin Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Antipsychotic Agents
Tranquilizing Agents
Central Nervous System Depressants processed this record on April 28, 2017