Avaliação da manobra de reposicionamento de Epley em indivíduos com vertigem posicional paroxística benigna
Assessing Epley's maneuver for benign paroxysmal positioning vertigo
Viviane de Souza Pinho Costa; Luciana Lozza de Moraes Marchiori; Juliana Jandre Melo; Fernando Raphael Pinto Guedes Rogério; Mariana Kuss Amâncio; Any Danielle Fontana; Camila Gonçalves do Nascimento
Resumo
Objetivo: verificar a resposta dos parâmetros estabilométricos à manobra de reposicionamento de Epley em indivíduos com VPPB previamente confirmada através da manobra de Dix-Hallpike.
Métodos: trata-se de um estudo quantitativo, descritivo e experimental, que incluiu pacientes com VPPB, com nistagmo de posicionamento à prova de Dix-Hallpike, avaliados em 2008, no Ambulatório Multidisciplinar de Vertigem, que foram submetidos à manobra de reposicionamento de Epley e avaliados por meio do exame estabilométrico, antes e após a manobra.
Resultados: Os 13 indivíduos do gênero feminino com idades entre 15 e 78 anos com diagnóstico de VPPB que foram selecionados para a pesquisa apresentaram melhora estatisticamente significante em relação ao equilíbrio postural após a manobra de Epley, em todos os parâmetros analisados, nos dois exames realizados.
Conclusão: nesta pesquisa a manobra de Epley mostrou ser um procedimento de importante intervenção para melhora das respostas do equilíbrio postural nos indivíduos com VPPB, avaliados por meio da estabilometria.
Palavras-chave
Abstract
Purpose: to evaluate the stabilometry parameters after Epley's maneuver in individuals with BPPV previously confirmed through Dix-Hallpike maneuver.
Methods: an experimental study which included patients with BPPV with positional nystagmus taking Dix-Hallpike's test and assessed in 2008, at the Multidisciplinary Vertigo Ambulatory, and who were also submitted to Epley's maneuver and assessed as for their postural balance through a stabilometry exam, both before and after such maneuver.
Results: the 13 female subjects with ages ranging from 15 to 78 years with previously confirmed BPPV, who were selected for the research, showed a significant statistically improvement regarding their postural balance after Epley's maneuver in all analyzed parameters as for both exams.
Conclusion: in this research the Epley's maneuver was shown as a procedure of important intervention for improving the answers of postural balance in individuals with BPPV evaluated by the stabilometry.
Keywords
Referencias
1. Burlamaqui JC, Campos CAH, Mesquita Neto O. Manobra de Epley para Vertigem Postural Paroxística Benigna: revisão sistemática. Acta Otorrinolaringol. 2006; 24(1):38-45.
2. Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol. 1952; 45(6):341-54.
3. Epley JM. The canalith reposiotining procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992; 107(3):399-404.
4. Duarte M. Análise estabilográfica da postura ereta humana quase estática. [livre-docência]. São Paulo (SP): Universidade de São Paulo; 2000.
5. Teixeira LJ, Machado JNP. Manobras para o tratamento da vertigem posicional paroxística benigna: revisão sistemática da literatura. Rev Bras Otorrinolaringol. 2006; 72(1):130-9.
6. Norré ME, Forrez G. Posture testing (posturography) in the diagnosis of peripheral vestibular pathology. Arch Otorhinolaryngol. 1986; 243(3):186-9.
7. Woodworth BA, Gillespie MB, Lambert PR. The canalith repositioning procedure for benign positional vertigo: a meta-analysis. Laryngoscope. 2004; 114(7):1143-6.
8. Steenerson RL, Cronin GW, Marbach PM. Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo. Laryngoscope. 2005; 115(2):226-31. http://dx.doi.org/10.1097/01.mlg.0000154723.55045.b5
9. Helminski JO, Janssen I, Kotaspouikis D, Kovacs K, Sheldon P, McQueen K, et al. Strategies to prevent recurrence of benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg. 2005; 131(4):344-8.
10. Richard W, Bruintjes TD, Oostenbrink P, van Leeuwen RB. Efficacy of the Epley maneuver for posterior canal BPPV: a long-term, controlled study of 81 patients. Ear Nose Throat J. 2005; 84(1):22-5.
11. Marchiori LLM, Rego Filho EA. Queixa de vertigem e hipertensão arterial. Rev CEFAC. 2007; 9(1):116-21. http://dx.doi.org/10.1590/S1516-18462007000100015
12. Hansson EE, Mansson NO, Hakansson A. Benign Paroxysmal Positional Vertigo among elderly patients in primary health care. Gerontol. 2005; 51(6):386-9. http://dx.doi.org/10.1159/000088702
13. Inukai K, Koizuka I, Takahashi S. Head-tilting stabilometry in patients with benign paroxysmal positional vertigo. Auris Nasus Larynx. 2008; 35(1):31-5. http://dx.doi.org/10.1016/j.anl.2007.06.007
14. Sridhar S, Panda N, Raghunathan M. Efficacy of particle repositioning maneuver in BPPV: a prospective study. Am J Otolaryngol. 2003; 24(6):355-60.
15. Lynn S, Pool A, Rose D, Brey R, Suman V. Randomized trial of the canalith repositioning procedure. Otolaryngol Head Neck Surg. 1995; 113(6):712-20.
16. Korn GP, Dorigueto RS, Gananca MM, Caovilla HH. Repeated Epley's maneuver in the same session in benign positional paroxysmal vertigo. Rev Bras Otorrinolaringol. 2007; 73(4):533-9.
17. Lorin P. Benign paroxysmal positional vertigo of the anterior semicircular canal: clinical aspects and treatment. Rev Laryngol Otol Rhinol (Bord). 2005; 126(4):263-6.
18. Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F, Ziese T, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006; 67(6):1028-33.
19. Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Arch Int Med. 2008; 168(19):2118 -24.
20. Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al. Epidemiology of vestibular vertigo. A neurotologic survey of the general population. Neurology. 2005; 65:898-904.
21. Levandowski MA, Bueno VK, Marchiori LLM, Melo JJ. Vertigem no idoso: relato de caso. Rev. CEFAC. 2008; 10(4):588-91. http://dx.doi.org/10.1590/S1516-18462008000400019
22. Sauvage JP, Aubry K, Codron S. Benign paroxysmal positional vertigo of the horizontal and superior semicircular canals. Rev Laryngol Otol Rhinol (Bord). 2005; 126(4):257-62.
Submitted date:
16/08/2009
Accepted date:
13/12/2009
