What is Epley Maneuver?
This treatment is used for a specific type of vertigo, called benign paroxysmal positional vertigo (BPPV)
, which is caused by tiny calcium crystals dislodging in the inner ear and brushing against nerves that control balance. When that happens, the wrong signals are sent to the brain, causing disorientation and dizziness.
CHECK OUT STEP-BY-STEP EPLEY MANEUVER GUIDE
(click on the infographic below)
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It’s not known what causes the fragments to dislodge but most sufferers are aged over 40, so experts think it could be part of the ageing process. In some cases, it could be due to a knock to the head or an inner ear infection like labyrinthitis.
It causes intense vertigo, which typically lasts no longer than a minute. An attack is triggered by a change in head position – often getting out of bed, rolling over or just looking up.
The Epley maneuver, usually performed by a doctor or therapist, involves four separate head movements designed to use gravity to move the crystals back to a place where they will no longer cause symptoms.
How does it work?
The treatment takes place on the doctor’s couch and usually takes just a few minutes to complete. During treatment, each head position is held for at least 30 seconds and movements between conducted quickly. The patient may experience vertigo during the Epley maneuver.
- The patient starts sitting upright with their head turned 45 degrees to the affected side.
- They are laid backwards with their head hanging 30 degrees over the edge of the couch and the affected ear to the ground.
- Next, their head is rotated by 90 degrees to face the opposite side.
- The head is held here as the patient rolls their body onto its side.
- The head is rotated so they are facing downward with their nose 45 degrees below horizontal.
- The patient sits up sideways keeping the head in position.
This Youtube video, which demonstrates the practice, has been viewed by more than 1.5 million people. Other demonstration films are available.
Some experts recommend aids for conducting the treatment yourself. The DizzyFix, for example, is a device worn to help you get the Epley maneuver right.
How should I prepare?
Before treatment, health professionals recommend you:
- Inform your doctor if you have neck or back problems as the exercise involves rotating the head.
- Tell your doctor of any problems with high blood pressure or history of detached retina.
- Don’t eat for a few hours as the manoeuvre can trigger vertigo and nausea.
- Take any medications you have been prescribed to prevent vertigo and nausea symptoms.
Afterwards, you may want to avoid driving home and avoid sudden head movements.
Symptoms should improve shortly after the procedure, although it can take up to 2 weeks to see a full recovery.
The treatment is effective in about 80% of cases and can be repeated.
If symptoms have not improved after 4 weeks return to your GP. It could be that your symptoms are due to a different condition and could not be treated by Epley maneuver.
However, even if treatment is not successful patients should be optimistic as BPPV
is a condition that often goes away on its own after several weeks or months on its own. The crystals are thought either to dissolve or move to a place within the inner ear where they cause no symptoms.
What if it didn’t work for you?
Look at this professional perspective of increasing your odds to success with BPPV treatment here