“Then you have someone walking around who is not only dizzy, but also sedated.” Many physicians prescribe medicines for patients with BPPV, which can be a problem because many of these drugs are sedating, said Dr. Kerber.īecause dizziness bridges several specialties, including general medicine, otolaryngology, and neurology, information on the Epley maneuver may “fall through cracks,” he said. “When I talk to medical students, they may have heard of it, but they don’t know how to do it,” said Dr. Physicians do not appear to be recommending this treatment, or even learning about it. Kerber, can be done only through a randomized controlled trial. The authors rated the videos only on their accuracy and did not rank their quality in terms of outcome. “In that case, they waste time rolling themselves around and delaying potential treatment,” said Dr. What could potentially be dangerous, however, is if a patient has a stroke, looks the symptoms up on YouTube, comes across one of these videos, and mistakes the symptoms for BPPV. “If you do that, the particles can fall in the opposite direction to where you want them to go,” he said.Īlthough inaccurate movements could fail to remove particles from the canal, the maneuver is, for the most part, very safe in that it involves no more than lying down and rolling over. In some videos, the movements were too slow, or the head was lifted during the rollover step. “Some of the videos just had the person lay back flat, which we don’t think would get the particles to move enough to be effective.” “One of the key things about the maneuver is lying all the way back with the head way back, kind of on the end of a table,” said Dr. Reasons for inaccuracies included things such as patients turning their head more than 45 degrees, or the head not being extended back far enough. However, none of the videos included complete diagnostic information about BPPV. Most videos (82%) provided accurate time spent on each position. ![]() The researchers rated almost two thirds of the videos (64%) as accurate demonstrations of the maneuver. That video, along with 4 others, accounted for 85% of hits for all videos. ![]() The most widely viewed video (with 802,471 hits) was produced in 2008 by the Practice Parameter on BPPV of the American Academy of Neurology (AAN). The total number of hits for all videos was 2,755,607. Most seemed to have been made by healthcare providers, including physicians and physical therapists, but some were likely made by patients in their home. The videos appeared to come from a number of different sources, said Dr. Researchers also determined whether the videos included diagnostic information and were accurate in the time spent on each position of the maneuver (most should last at least 20 seconds). They categorized the videos as demonstrating guided treatment or self-treatment, and as showing the maneuver for right-sided BPPV, left-sided BPPV, or both. “There haven’t been that many studies looking at this, but every one of them suggests that this maneuver is underutilized.” It is possible that physicians recommend the maneuver but just do not record it, he said.Īfter performing a systematic search and selecting videos that demonstrated the entire Epley maneuver and that were available on YouTube up to August 30, 2011, researchers abstracted information from each video, including its duration, posting date, and number of views, and related comments from viewers. Kerber, however, this treatment is not widely used. “If you want to treat someone effectively, this is it.”Īccording to Dr. The maneuver has been proven effective in rigorous randomized trials and is included in guidelines on treating BPPV, said Dr.
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