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Epley Maneuver

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Epley Maneuver

ENT- Otolaryngology | by CMRI | Published on 10/08/2020

An Epley maneuver is a form of exercise, which can be performed at home to relieve dizziness because of benign paroxysmal positional vertigo (BPPV). BPPV is a condition that occurs when calcium crystals known as canaliths accumulate in the semi-circular canals of the inner ear. These crystals eventually get dislodged and start to move around, sending sensations to the body that the world is spinning or moving too fast. This particular sensation issue is also medically called vertigo.


Epley maneuver helps to remove these accumulated crystals from the semi-circular canals. This form of home exercise is very beneficial for patients suffering from BPPV. More so, in cases, where some specific head movements tend to cause severe vertigo. Epley maneuver is very beneficial for people of all ages and usually relieves symptoms immediately. But in some cases, the exercise might need to be practiced for a longer time to be able to heal the issue.


How to perform an Epley maneuver?


A person who wants to perform Epley maneuver himself or herself can follow these simple steps below. The below steps are particular for patients that have a problem in the left ear. However, for people with an issue in the right ear, the steps remain the same, but their head needs to turn in the opposite direction.


Step 1: Sit up on the bed and place your legs flat on the bed right in front of you. Once in position, turn your head 45 degrees to the left.


Step 2: Lie down slowly, while keeping the head in the left direction, and hold the stance for 30 seconds.


Step 3: Post this, turn the head to 90 degrees right, till the time it is at 45 degrees to that side. This posture needs to be held for 30 seconds.


Step 4: Release and rollover on the right side before sitting right up


How to gain maximum benefits from an Epley maneuver?


Since the success of this form of treatment is dependent on the correctness of the posture, it is advisable to perform the exercise for the first time under the guidance or supervision of the health care provider. They can assist in ensuring you correctly perform the exercise and get relief at the earliest.


In most cases, the symptoms are relieved almost immediately after performing an Epley maneuver. However, in some cases, the technique would need to be performed again. For some patients, it is advised to do the Epley maneuver thrice before going to sleep. This is suggested so that even if a person experiences vertigo or dizziness after the exercise, sleeping can help with the issue and allow the patient to rest.


In all, even though the Epley maneuver has shown improvement in patients suffering from BPPV but it is not as effective in other forms of vertigo. Hence, while an Epley maneuver is considered a safe exercise for all types of patients, it is advisable to still ask the doctor before going ahead.


Also, in case the patient has the following issues, the doctor must be consulted before doing the exercise:


  • Disease or injury in the neck or back
  • Vascular conditions
  • Retinal detachment


What if the symptoms don’t improve?


In case, if the patient still feels dizzy after the Epley maneuver, it is important to consult a doctor at the earliest. The healthcare provider can check your posture in the exercises and the steps followed to help you correct your form and reduce the symptoms. In other cases, the doctor can also provide alternate treatment methods to treat the issue.


An alternate form of treatment for the Epley maneuver is also canalith repositioning maneuver. In this, a certain type of head and body movement can help to remove the crystals from the canal of the inner ear and push it a different part of the ear, where the body of the patient can absorb it easily.


In some cases, the doctor can also recommend nausea or motion sickness medications to treat the symptoms. Also, since the Epley maneuver can only treat BPPV cases, it would be wise to check with the doctor, if the dizziness, nausea, etc. is because of another underlying condition such as anaemia, migraine, or an ear infection.


How needs an Epley maneuver?


As specified, a person suffering from symptoms of BPPV will need to perform an Epley maneuver to treat the issue. Some of the common symptoms of BPPV include:


  • Incoming and outgoing vertigo upon certain head movements. This typically lasts for a minute.
  • Nausea and vomiting


Most often, BPPV can occur without a specific underlying cause. However, in other cases, there may be issues, such as below, causing BPPV:


  • An injury to the head
  • After-effects of the ear surgery


Overall, an Epley maneuver is very safe and can be effectively performed at home to treat patients suffering from BPPV. The confirmation of BPPV will be made by a physical exam and based on the medical history of the patient. In some severe cases, the healthcare provider can also recommend a vestibular therapist to treat the issue.


The doctor will first perform the procedure in front of the patient, allowing them to learn the right technique and postures. Usually, it is very effective in the first time. However, in other cases, the patient might need to revisit the doctor if the symptoms continue even after the exercise.