Benign Paroxysmal Positional Vertigo (BPPV)NCT07111000
Testing the Epley Maneuver for Treating Dizziness in the Emergency Department
A study testing Epley Maneuver in people with Benign Paroxysmal Positional Vertigo (BPPV), run by American University of Beirut Medical Center at 1 site in Lebanon.
Trial summary
The goal of this randomized controlled trial is to evaluate the efficacy of the Epley maneuver versus a sham maneuver in treating patients presenting to the emergency department (ED) with BPPV. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Benign Paroxysmal Positional Vertigo (BPPV)
- What is being tested?
- Epley Maneuver
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 118 participants
- Where
- 1 siteLebanon
- Study dates
- 1 Aug 2024to 22 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age: above 18 years old
- Patients presenting to the ED with symptoms of BPPV (single or recurrent episodes of vertigo lasting up to 2 minutes) and a positive DHT (episode of vertigo associated with torsional upbeating nystagmus) indicating a posterior semicircular canal BPPV.
- Patients who are able to understand and provide a signed informed consent to participate in the study Exclusion Criteria
- Severe cervical diseases (e.g., soft tissue disorders, cervical spondylosis, prolapsed intervertebral disks and severe rheumatoid arthritis with cervical instability …)
- Unstable cardiovascular diseases (e.g., hemodynamically unstable, decompensated heart failure, acute myocardial infarction, decompensated valvular diseases, severe arrhythmias …)
- Suspected vertebrobasilar diseases (e.g., cerebellar signs, vision changes, numbness or tingling in the extremities, slurred speech, changes in mental status, confusion …)
Show all 17Show fewer
- History of high-grade carotid stenosis
- Recent (<24 hours) intake of aminoglycosides, chemotherapeutic agents, cyclophosphamide, loop diuretics, or quinines
- Patients with peripheral causes of vertigo other than BPPV (such as Meniere's disease or vestibular neuritis)
- Patients with central causes of vertigo (vestibular migraine, Arnold Chiari malformation, history of CNS tumor(s), multiple sclerosis)
- Patients with focal deficits on neurological exam
- Patients with an episode of vertigo lasting more than 2 minutes
- Patients with a negative DHT
- Patients with pure horizontal or vertical nystagmus
- Patients with lateral and anterior semicircular canals BPPV
- Participants refusing to undergo Epley maneuver
- Pregnancy beyond the 24th week of gestation
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Evaluating the Efficacy of Epley Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department: A Randomized Controlled Trial.
The goal of this randomized controlled trial is to evaluate the efficacy of the Epley maneuver versus a sham maneuver in treating patients presenting to the emergency department (ED) with BPPV. The main questions that the study aims to answer are:
- What is the mean difference in Dizziness Handicap Inventory (DHI) scores between patients receiving the Epley maneuver and those receiving the sham maneuver 3 days after enrollment?
- What is the immediate response (using a 0-10-point Likert scale) of patients in each arm of the study?
- What is the proportion of patients who, despite agreeing to participate, were unable to complete the full Epley maneuver due to symptom severity?
Read more
Researchers will compare the Epley maneuver arm to the sham maneuver arm to see if the Epley maneuver is more effective in reducing BPPV symptoms.
Participants will:
- Undergo either the Epley maneuver or a sham maneuver.
- Complete the Dizziness Handicap Inventory (DHI) questionnaire at baseline and 3 days post-discharge.
- Patients with insufficient improvement in the sham maneuver group will receive a rescue Epley maneuver.
- Have their vertigo severity assessed using a 0-10 point Likert scale at baseline, immediately and post-maneuver.
- Being tested
- Epley Maneuver, Sham maneuver
- Keywords
- Epley, vertigo, bening paroxysmal positional vertigo
- Medical subject headings
- Benign Paroxysmal Positional Vertigo, Vertigo
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Epley ManeuverProcedure or surgery
The patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds
Sham maneuverProcedure or surgery
This control maneuver will involve coordinated movements of the hands and legs, while excluding any head movement. Patients will be at first in a sitting position with both feet on the ground and both hands placed on the thighs and then they will be asked to lift both hands off the thighs, keeping the arms extended. They will then be asked to return to their initial upright sitting position. Patients will then raise their right foot off the ground while keeping the left one planted on the ground. It will be an alternating movement between lifting the right and left feet while maintaining a smooth and well- controlled rhythm for 90 seconds.
| Study group | Role | What they receive |
|---|---|---|
| Epley Maneuver | Experimental | The patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds Receives: Procedure: Epley Maneuver |
| Sham Maneuver | Sham comparator | This maneuver will involve coordinated movements of the hands and legs, while excluding any head movement. Patients will be at first in a sitting position with both feet on the ground and both hands placed on the thighs and then they will be asked to lift both hands off the thighs, keeping the arms extended. They will then be asked to return to their initial upright sitting position. Patients will then raise their right foot off the ground while keeping the left one planted on the ground. It will be an alternating movement between lifting the right and left feet while maintaining a smooth and well-controlled rhythm for 90 seconds. Receives: Procedure: Sham maneuver |
What is being measured
The primary outcome is the main question the study is designed to answer.
Efficacy of Epley
The study will compare the average Dizziness Handicap Inventory score change from baseline to day 3 between the Epley maneuver group and the sham maneuver group. The DHI is a 25-item self-administered questionnaire designed to assess the effects of dizziness on various aspects of life, including functional, emotional, and physical domains. Scores range from 0, indicating no disability, to 100, representing severe disability. This scale enables patients to indicate how much dizziness interferes with their daily activities. A higher score reflects a greater perceived handicap caused by dizziness.
Measured: 3 days
Secondary outcomes (3)
Immediate response of patients
The severity of vertigo will be evaluated using both a 0 to 10-point Likert scale before and after applying the Epley/Sham maneuver.
Measured: 15-30 minutes after intervention
Rate of bounce-back to the ED
Calculate the proportion of patients in each arm of the study who return to the ED.
Measured: 3 days
Proportion of patients unable to undergo the full Epley maneuver
The percentage of patients who agreed to participate but could not complete the Epley maneuver due to the severity of their symptoms.
Measured: 15 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Aug 2025
- Study start1 Aug 2024
- Primary completion22 Jul 2026 (estimated)
- Study completion22 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Benign Paroxysmal Positional Vertigo (BPPV)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 118 participants (estimated)
Sponsor and investigators
- Lead sponsor
- American University of Beirut Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Eveline Hitti, American University of Beirut Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07111000
- Sponsor's protocol ID
- BIO-2023-0184
- Status last verified
- May 2026
- First submitted
- 6 Aug 2025
- Last updated
- 11 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating the Efficacy of Epley Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department: A Randomized Controlled Trial.
- ClinicalTrials.gov ID
- NCT07111000
- Acronym / sponsor ID
- BIO-2023-0184
- Keywords
- Epley, vertigo, bening paroxysmal positional vertigo
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 118 participants (estimated)
- Lead sponsor
- American University of Beirut Medical CenterUniversity, hospital or other
- Study start
- 1 Aug 2024 (actual)
- Primary completion
- 22 Jul 2026 (estimated)
- Study completion
- 22 Aug 2026 (estimated)
- First posted
- 8 Aug 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this randomized controlled trial is to evaluate the efficacy of the Epley maneuver versus a sham maneuver in treating patients presenting to the emergency department (ED) with BPPV. The main questions that the study aims to answer are:
- What is the mean difference in Dizziness Handicap Inventory (DHI) scores between patients receiving the Epley maneuver and those receiving the sham maneuver 3 days after enrollment?
- What is the immediate response (using a 0-10-point Likert scale) of patients in each arm of the study?
- What is the proportion of patients who, despite agreeing to participate, were unable to complete the full Epley maneuver due to symptom severity?
Researchers will compare the Epley maneuver arm to the sham maneuver arm to see if the Epley maneuver is more effective in reducing BPPV symptoms.
Participants will:
- Undergo either the Epley maneuver or a sham maneuver.
- Complete the Dizziness Handicap Inventory (DHI) questionnaire at baseline and 3 days post-discharge.
- Patients with insufficient improvement in the sham maneuver group will receive a rescue Epley maneuver.
- Have their vertigo severity assessed using a 0-10 point Likert scale at baseline, immediately and post-maneuver.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Epley Maneuver | Experimental | Procedure: Epley ManeuverThe patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds |
| Sham Maneuver | Sham comparator | Procedure: Sham maneuverThis maneuver will involve coordinated movements of the hands and legs, while excluding any head movement. Patients will be at first in a sitting position with both feet on the ground and both hands placed on the thighs and then they will be asked to lift both hands off the thighs, keeping the arms extended. They will then be asked to return to their initial upright sitting position. Patients will then raise their right foot off the ground while keeping the left one planted on the ground. It will be an alternating movement between lifting the right and left feet while maintaining a smooth and well-controlled rhythm for 90 seconds. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- Age: above 18 years old
- Patients presenting to the ED with symptoms of BPPV (single or recurrent episodes of vertigo lasting up to 2 minutes) and a positive DHT (episode of vertigo associated with torsional upbeating nystagmus) indicating a posterior semicircular canal BPPV.
- Patients who are able to understand and provide a signed informed consent to participate in the study Exclusion Criteria
- Severe cervical diseases (e.g., soft tissue disorders, cervical spondylosis, prolapsed intervertebral disks and severe rheumatoid arthritis with cervical instability …)
- Unstable cardiovascular diseases (e.g., hemodynamically unstable, decompensated heart failure, acute myocardial infarction, decompensated valvular diseases, severe arrhythmias …)
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Epley ManeuverThe patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds | Procedure or surgery | Epley Maneuver |
| Sham maneuverThis control maneuver will involve coordinated movements of the hands and legs, while excluding any head movement. Patients will be at first in a sitting position with both feet on the ground and both hands placed on the thighs and then they will be asked to lift both hands off the thighs, keeping the arms extended. They will then be asked to return to their initial upright sitting position. Patients will then raise their right foot off the ground while keeping the left one planted on the ground. It will be an alternating movement between lifting the right and left feet while maintaining a smooth and well- controlled rhythm for 90 seconds. | Procedure or surgery | Sham Maneuver |
Primary outcome
Efficacy of Epley
Time frame: 3 days
The study will compare the average Dizziness Handicap Inventory score change from baseline to day 3 between the Epley maneuver group and the sham maneuver group. The DHI is a 25-item self-administered questionnaire designed to assess the effects of dizziness on various aspects of life, including functional, emotional, and physical domains. Scores range from 0, indicating no disability, to 100, representing severe disability. This scale enables patients to indicate how much dizziness interferes with their daily activities. A higher score reflects a greater perceived handicap caused by dizziness.
3 secondary outcomes
Immediate response of patients
Time frame: 15-30 minutes after intervention
Rate of bounce-back to the ED
Time frame: 3 days
Proportion of patients unable to undergo the full Epley maneuver
Time frame: 15 minutes
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 May 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Epley Maneuver in people with Benign Paroxysmal Positional Vertigo (BPPV), run by American University of Beirut Medical Center at 1 site in Lebanon.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 17 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 11 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Lebanon. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Eveline Hitti, MD (00961-1-350000 ext. 6616, eh16@aub.edu.lb), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Efficacy of Epley (time frame: 3 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 May 2026.