Review of 33 Videos of Epley Maneuver Shows Most Accurate; Other Experts Urge Caution
By Kathleen Doheny
WebMD Health News
Latest Neurology News
Reviewed by Louise Chang, MD
July 23, 2012 -- Watching self-help videos on the popular Internet site YouTube may help some people with vertigo treat themselves.
A new study found 33 videos showing the Epley maneuver. This maneuver is often used by heath care providers to help people with benign paroxysmal positional vertigo, or BPPV.
The researchers rated the accuracy of the 33 videos, including one produced by the American Academy of Neurology (later posted by a viewer on YouTube) that got the most page views.
The Epley maneuver, often done by health care providers who diagnose the condition, can be done in a few minutes. The patient lies down, turns, and moves in various ways.
Video-sharing media such as YouTube may be an important way to let people know about effective interventions such as the Epley maneuver, the researchers say. The study, published in the journal Neurology, rated 21 (or 64%) of the videos as accurate.
"If used properly, these videos could mean reduced clinical visits for patients who successfully perform it at home," says Mary Jane Lim Fat, MD, a resident in neurology at the University of Toronto. She reviewed the study findings and has published research on using YouTube videos to help parents understand infantile spasms.
The researchers note that although some patient users reported that self-treatment helped, others reported no improvements or worse symptoms after the maneuver.
Experts had some caveats. First, make sure you really have the BPPV form of vertigo before trying to treat it. Second, make sure you use a video that is recommended by a health care professional or is from a professional association, such as the American Academy of Neurology.
YouTube for Vertigo Treatment: Details
BPPV is thought to be caused by particles made up of loose calcium deposits that move around freely in the inner ear, the researchers say.
The Epley maneuver is designed to move the particles out of the canal and into an area of the ear where they do not cause any symptoms.
"Getting an accurate diagnosis before treatment is really important," says Cynthia Ryan, executive director of the Vestibular Disorders Association, a patient member group.
"We believe everyone should be consulting their health care professionals before self-diagnosing and treating themselves," she says.
The videos are a commonly used patient education tool, she says. People with BPPV should be sure their health care provider approves of a video they want to use, Ryan says.
Fat also offers these caveats:
- YouTube videos are not reviewed by medical professionals before posting (excluding the Academy video).
- Comments can be made by anyone viewing the videos and are not always relevant.
- Most videos highlight the risk, but some might not warn patients enough. "This is particularly relevant in patients who would normally be advised against the maneuver, for example [due to a] neck or back injury.''
- People who use the videos need to get medical help when first diagnosed, when their vertigo worsens or changes, or if they notice new symptoms.
- Some videos are better than others. "Videos hand-picked and recommended by health care professionals or authoritative associations such as the American Academy of Neurology are of much greater value than individual searches on YouTube," she says.
Lead researcher Kevin Kerber, MD, a neurologist at the University of Michigan, reports receiving speaker honoraria from the American Academy of Neurology, Munson Medical Center, and the University of Utah.
He was a consultant for the academy and a one-time consultant for Pierre Fabre and expert witness for Estes, Ingram, Foels & Gibbs, P.A.
Coauthors report consultant work for Abbott, AstraZeneca Pharmaceuticals, and other drug companies, and travel funding from Johnson & Johnson.
SOURCES: Kerber, K. Neurology, published online July 24, 2012. Cynthia Ryan, MBA, executive director, Vestibular Disorders Association, Portland. Mary Jane Lim-Fat, MD, neurology resident, University of Toronto.
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