These steps may be repeated twice, for a total of three times during a procedure.

The patient holds a sitting position for up to 30 seconds.

Finally, the patient is slowly brought up to an upright sitting posture, while maintaining the 45-degree rotation of the head.

The eyes should be observed immediately by the clinician for “secondary stage” nystagmus (this secondary stage nystagmus should be in the same direction as the primary stage nystagmus).

Now the patient is looking downward at a 45-degree angle.

Keeping the head and neck in a fixed position relative to the body, the patient rolls onto the shoulder, rotating the head another 90 degrees in the direction being faced.

Then the patient's head is rotated 90 degrees in the opposite direction, so that the opposite ear faces the floor, while maintaining 30 degrees of neck extension.

The patient remains in this position for approximately 1–2 minutes.

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. Maneuver used by medical professionals to treat one common cause of vertigo

Epley maneuver for dizziness vertigo