It is also known as Epley maneuver. It is one of the simple method to cure Benign positional Vertigo. The maneuver if done for repeated several times, the intensity of the vertigo and nystagmus decreases (habituation). It is also called as particle repositioning maneuver.

 

It is a form of vestibular rehabilitation therapy, to move the displaced debris out of one of the semicircular canals so to stop the false signals and the debilitating symptoms they can cause. It is very effective method to treat BPV.

Some individuals experience vertigo when they change the position of their head suddenly, as when rolling their head on the pillow, looking down to tie their shoes, or looking up to reach for an item on a high shelf. This vertigo is usually due to benign paroxysmal positional vertigo (BPPV). It occurs when tiny calcium particles are displaced from their normal location to form sludge or mass in the posterior semicircular canal. The Epley maneuver helps to move the particles out of the canal and back to normal position from where they originated.

This maneuver should be done by your doctor or physical therapist

In this maneuver, the person's body and head are moved into different positions, one after the other. Each position is maintained for about 30 seconds to allow the particles to move by gravity into a different part of the canal. To check if the maneuver worked, the person moves the head in the same way as previously caused vertigo. If vertigo does not occur, the maneuver worked.

Procedure

It involves sequential movements into three positions:

• Sitting up
• Sitting up to lying down
• Lying down to rolling over
• Return to the sitting position

Each position is maintained for 1-4 minutes or at least until the symptoms of vertigo and nystagmus has disappeared for at least 30 seconds. The maneuvers include the following steps:

• The patient is asked to sit up with head turned 45 degrees to the affected side.
• The patient is tilted back to a horizontal position on a table so that the head is hanging slightly off the edge of the table while the position of the head is still turned 45 degrees towards the affected side.
• The head is rotated slowly so that the unaffected ear is beneath the head.

• The patient is rotated towards the unaffected side and the head is rotated further so that the individual is looking down at the floor.

• The patient is then slowly returned to the sitting position and the head is rotated back to a central position.

Care after the procedure

• Avoid bending over.
• Avoid tilting of head backwards.
• Avoid lying flat on bed. Maintain propped up position.

• Avoid turning towards the affected side while sleeping.

• Avoid lying on the side of affected ear for one week

Side effects of this maneuver

• Nausea and vomiting.
• Patient with cervical spondylosis may experience pain during the procedure.