Epley maneuver

Epley Maneuver

Illustration of the Epley Maneuver

The Epley Maneuver is a series of head and body movements used to treat benign paroxysmal positional vertigo (BPPV), a disorder arising from a problem in the inner ear. The maneuver is designed to move otoliths or canaliths from the semicircular canals of the inner ear back to the utricle, where they can no longer cause symptoms.

History

The Epley Maneuver was developed by Dr. John Epley in 1980. It is one of the most commonly used procedures for treating BPPV and has been shown to be highly effective in resolving symptoms in a majority of patients.

Procedure

The Epley Maneuver involves a sequence of specific movements:

1. The patient begins in a sitting position with their legs extended.
2. The head is turned 45 degrees towards the affected ear.
3. The patient is quickly laid back with the head hanging slightly over the edge of the examination table, maintaining the 45-degree head turn.
4. The head is then turned 90 degrees to the opposite side.
5. The body is rolled in the same direction until the patient is lying on their side, with the head facing downward.
6. Finally, the patient is brought back up to a sitting position.

Each position is held for about 30 seconds or until any vertigo symptoms subside.

Mechanism

The Epley Maneuver works by moving the dislodged otoliths through the semicircular canals and back into the utricle. This repositioning helps to alleviate the abnormal signals sent to the brain that cause vertigo.

Effectiveness

The Epley Maneuver is considered highly effective, with success rates reported as high as 90% in resolving symptoms of BPPV. It is a non-invasive treatment and can often be performed in a clinical setting or at home with proper instruction.

Complications

While generally safe, the Epley Maneuver can occasionally cause complications such as:

• Nausea
• Vomiting
• Temporary worsening of vertigo

Patients are advised to perform the maneuver under the guidance of a healthcare professional, especially during the initial treatment.

Related Pages

• Benign paroxysmal positional vertigo
• Otolith
• Semicircular canals
• Inner ear