Epley maneuver

Benign Paroxysmal Positional Vertigo is a clinical diagnosis characterised by episodes of objective vertigo lasting less than 60 seconds, occuring as a result of certain head positions. This condition may lead to nausea and nystagmus, a rapid and involuntary movement of the eyes.

Several maneuvers have been developed to reposition otoliths and treat some forms of vertigo, also known as labyrintholithiasis. Epley's maneuver serves as the therapeutic intervention for Benign Positional Paroxysmal Vertigo (BPPV).

The maneuver is divided into three distinct steps:

• Step 1: The physician seats the patient on the couch, holds the patient's head with their hands, and swiftly rotates it 45 degrees to the right or left, depending on the treatment. Simultaneously, the patient is guided to lie down, ensuring the head ends up slightly lower than the trunk.
• Step 2: The physician further rotates the patient's head by 90 degrees, transitioning from a 45-degree right rotation to a 45-degree left rotation, maintaining this position for an additional 30 seconds.
• Step 3: The physician asks the patient to rotate to the left, shifting weight onto the left shoulder with their face facing floor of the room. A resting period in this position lasts for another 30 seconds.

Upon completion of the third phase, the patient returns to the initial sitting position on the couch. Keep in mind that these maneuvers should not be attempted without the assistance of a trained medical professional.

The Epley maneuver is considered a safe maneuver. 

However, there are potential risks if it is not performed correctly.

These include: 

• Possible injuries to the neck or back.
• Temporary worsening of vertigo symptoms.
• Irritation of the vestibular apparatus within the inner ear.