The clinician observes the patient's eyes for “primary stage” nystagmus.Then the patient is quickly lowered into a supine position (on the back), with the head held approximately in a 30-degree neck extension ( Dix-Hallpike position), with the head remaining rotated to the side.The patient begins in an upright sitting posture, with the legs fully extended and the head rotated 45 degrees toward the side in the same direction that gives a positive Dix–Hallpike test.The following sequence of positions describes the Epley maneuver: The modified procedure has become that now described generally as the Epley maneuver.Īn Epley maneuver is a safe and effective treatment for BPPV, although the condition recurs in approximately one third of cases. Ī version of the maneuver called the 'modified' Epley does not include vibrations of the mastoid process originally indicated by Epley, as the vibration procedures have been proven ineffective. The maneuver was developed by the physician, John M. The maneuver works by allowing free-floating particles, displaced otoconia, from the affected semicircular canal to be relocated by using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo. The Epley maneuver or repositioning maneuver is a maneuver used by medical professionals to treat one common cause of vertigo, benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals of the ear.

Surgery can also relieve BPPV, but surgery is only rarely necessary.Maneuver used by medical professionals to treat one common cause of vertigo As well, some patients simply have too much debris in the posterior semi-circular canal to clear without surgery. Rarely, a more serious problem may initially look like Benign Paroxysmal Positioning Vertigo (BPPV). If the CRP does not seem to clear the problem, please allow us to evaluate you again. There is no limit to how many times the CRP can be re-done.Ideally, the head should not tip backwards more than 30 degrees which means that the back cannot be tilted backwards more than 30 degrees. When reclining for sleep, sleep as near upright as possible. Restrictions apply for the first 24 hours after the treatment.Do not tip head back to drink water but use a straw.

Keep chin straight forward to tipped down a bit.LEFT Ear Treatment: If vertigo occurs on left sideĪndrea Radtke, Hannelore Neuhauser, Michael von Brevern, Thomas Lempert Neurologische Klinik, Charité Berlin, Germany, 1999 RIGHT Ear Treatment: If vertigo occurs on right sideĪndrea Radtke, Hannelore Neuhauser, Michael von Brevern, Thomas Lempert Neurologische Klinik, Charité Berlin, Germany, 1999 Instructions after the Canalith Repositioning (CRP) maneuver: Contact us today to request an appointment. Benign Paroxysmal Positioning Vertigo is one of many balance disorders that we diagnose and treat at the Tampa Bay Hearing & Balance Center.

You may have a floating, swaying sense while walking or sitting for a few days after this procedure. Self-Treatment of Benign Paroxysmal Positional Vertigoīenign Paroxysmal Positioning Vertigo is caused by loose inner ear crystals in the inner ear that migrate while sleeping to the back-bottom inner ear balance canal, the so-called “posterior semi-circular canal.” The maneuver demonstrated below is the way to reposition the loose crystals so that the symptoms caused by the loose crystals go away. The Epley Maneuver demonstrated, is the way to reposition loose crystals in the ear, also known as Benign Paroxysmal Positioning Vertigo, so that the symptoms caused by the loose crystals go away.

Epley's maneuver vertigo