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Is YouTube a prescription for vertigo?

U-M researchers show accuracy of Epley maneuver videos available on web, but say efficacy is unknown

Photo Credit: Healthwise
The first step in the Epley maneuver

Issued by the American Academy of Neurology; used with permission

ANN ARBOR, Mich. - Watching videos on YouTube may be a new way to show the treatment for a common cause of vertigo, which often goes untreated by physicians, according to a study published in the July 24, 2012, print issue ofNeurology, the medical journal of the American Academy of Neurology.

Benign paroxysmal positional vertigo (BPPV) is an inner ear disorder that is a common cause of dizziness.

“This type of vertigo can be treated easily and quickly with a simple maneuver called the Epley maneuver, but too often the maneuver isn’t used, and people are told to ‘wait it out’ or given drugs,” said study author Kevin A. Kerber, M.D.,of the University of Michigan Health System in Ann Arbor and a member of the American Academy of Neurology. “We found that accurate video demonstrations of the maneuver that health care providers and people with vertigo can use are readily available on YouTube.” Kerber is an assistant professor of neurology at the U-M Medical School.

For the study, Kerber and his colleagues searched YouTube for videos showing the Epley maneuver and rated their accuracy. They also reviewed the comments posted regarding the videos to see how the videos were used.

“It was good to see that the video with the most hits was the one developed by the American Academy of Neurology when it published its guideline recommending the use of the Epley maneuver in 2008 and then posted on YouTube by a lay person,” Kerber said. “But it was also good that the majority of the videos demonstrated the maneuver accurately.”

Some comments showed that health care providers are using the videos as a prescribed treatment or to help patients learn about the maneuver. People with dizziness also seem to be using the videos to treat themselves.

“One shortcoming of the videos was that they did not include information on how to diagnose BPPV, and some of the comments indicate that people who do not have BPPV may be trying these maneuvers because of dizziness from other causes,” Kerber said. “Despite this, we found it encouraging to think that YouTube could be used to disseminate information about this maneuver and educate more people about how to treat this disorder.” Kerber and his colleagues are currently working on projects to test the effectiveness of video interventions on patient outcomes.

The disorder is likely caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear. The maneuver moves the calcium crystals out of the sensing tube and into another inner chamber of the ear, where they do not cause symptoms.

For more information about the AAN’s guideline on treating benign paroxysmal positional vertigo, visit www.aan.com/guidelines.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy

In addition to Kerber, the study's authors include James F. Burke, MD, Lesli E. Skolarus, MD, Brian C. Callaghan, MD of the U-M Medical School Department of Neurology, Terry D. Fife, MD, of the University of Arizona College of Medicine, Robert W. Baloh, MD, of the University of California, Los Angeles, and A. Mark Fendrick, MD of the U-M Medical School Department of Internal Medicine. Burke is a Robert Wood Johnson Clinical Scholar at U-M.

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Written by American Academy of Neurology

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