BPPV-Epley 'aftercare' instructions

[andilouuk]

I just wondered, what advice (if any, as I know some of you don't) do you give patients after an EPley or other PRM manoeuvre?

I'll start-in our department we have a leaflet explaining BPPV/Epley and it instructs the patient to avoid large/sudden head movements or lying flat in bed for 24 hours.

BUT, I don't know where the evidence for this, or the (albeit similiar) instructions neighbouring depts use came from. Or if it is all irrelevant and actually makes no difference to the efficacy of the manoeuvre at all?

References would be welcome

Thanks!

[Guy]

This was the subject of a CAC written exam question several years ago.
At that time the evidence (there had been one or two studies that looked out whether outcome was affected) suggested that it made no difference.
However, like you, we advise against lying flat (for 48 hrs) or doing anything to provoke their dizziness. We stress that holding themselves still is likely to give them (a) a stiff neck and (b) light-headedness so we ask them to move normally and freely - except don't lie flat.

[andilouuk]

Thanks Guy, I think if advice IS given, then it is fairly similar between centres. However I have been told by a couple of (experienced) colleagues in the UK that it is of no consequence. Before we revise our patient leaflets I'd quite like to know what is in them is valid. Although I don't know if any evidence out there would be enough to change our practice.

I think I need to work harder on my literature search.

*off to read Vestibular Rehabilitation with my magnifying glass*