Epley Maneuver For Benign Paroxysmal Positional Vertigo

The Epley maneuver or repositioning maneuver is a maneuver used to treat benign paroxysmal positional vertigo (BPPV). BPPV is a common cause of dizziness. It happens when tiny calcium particles get loose in the inner ear. The symptoms of BPPV include dizziness or vertigo, lightheadedness, imbalance, and nausea. BPPV can affect people of all ages, although it is most common in folks over the age of 60.

The disorder can often be cured by using the Epley maneuver to move floating particles from the affected semicircular canal to be relocated, using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo. In this maneuver, the person's body and head are moved into different positions, one after the other.

The following sequence of positions describes the Epley maneuver (each position is maintained for about 30 seconds):
  1. The patient begins in an upright sitting posture, with the legs fully extended and the head rotated 45 degrees to the right or left, depending on which side triggers the vertigo. (say the left)
  2. With the head still turned, the patient is reclined past the horizontal with shoulders on the pillow and neck extended (the head must not lie on the pillow).
  3. In the reclined position the head is turned to the right.
  4. The patient is rolled onto their right side. the head is still turned to the right; the patients is now looking towards the floor (hold for 30 seconds).
  5. The patient is sat upright, still look over their right shoulder.
  6. Finally, the patient is slowly brought up to an upright sitting posture, while maintaining the 45 degree rotation of the head.

Patients should repeat this daily until they are free from positional vertigo for 24 hours.

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