Contents

Search

Epley procedure/maneuver (canalith repositioning)

Indications: - self treatment procedure for benign positional vertigo* * has replaced Brandt-Daroff exercise as treatment of choice [3,4] * see Dix-Hallpike maneuver for assessment of benign positional vertigo Procedure: See [4,5,9] for depiction of the Epley maneuver Left-sided vertigo: 1) sit on a bed & turn your head 45 degrees to the left 2) lie back quickly with a pillow under your shoulders & head reclined onto the bed 3) wait 30 seconds 4) turn your head 90 degrees to the right keeping it on the bed 5) wait 30 seconds 6) turn your body & head another 90 degrees to the right 7) wait for 30 seconds 8) sit up on the right side Right-sided vertigo: 1) sit on a bed & turn your head 45 degrees to the right 2) lie back quickly with a pillow under your shoulders & head reclined onto the bed 3) wait 30 seconds 4) turn your head 90 degrees to the left keeping it on the bed 5) wait 30 seconds 6) turn your body & head another 90 degrees to the left 7) wait for 30 seconds 8) sit up on the left side Total time in exercise should be about 10 minutes. Mechanism of action: - the Epley maneuver designed to permit otolith debri originating in the utricle to pass through the semicircular canal & return to the utricle [3]

Related

benign positional vertigo; benign paroxysmal positional vertigo Dix-Hallpike maneuver vestibular rehabilitation

General

repositioning maneuver

References

  1. Journal Watch, Mass Med Soc 19(23):186 (Dec) 1999
  2. http://www.charite.de/ch/neuro/vertigo.html
  3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. Journal Watch 24(17):136, 2004 Radtke A, von Brevern M, Tiel-Wilck K, Mainz-Perchalla A, Neuhauser H, Lempert T. Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure. Neurology. 2004 Jul 13;63(1):150-2. PMID: 15249626 http://n.neurology.org/content/63/1/150.long
  5. Video 4 min 30 sec Web-Guided Canalith Reposition Maneuver JAMA Neurology. 2023. Jan 17 https://edhub.ama-assn.org/jn-learning/video-player/18751089
  6. Johns Hopkins Health Home Epley Maneuver https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/home-epley-maneuver
  7. Vertigo - Epley manoeuvre from BMJ Learning https://www.youtube.com/watch?v=jBzID5nVQjk
  8. Epley Maneuver: Performed on a Real Patient suffering from Vertigo https://www.youtube.com/watch?v=K4S4CbuN6QA
  9. Strupp M, Mandala M, Vinck AS et al The Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo. A Randomized Clinical Study. JAMA Neurol. 2023;80(8):798-804 PMID: 37358870 PMCID: PMC10425825 Free PMC article https://jamanetwork.com/journals/jamaneurology/fullarticle/2806601 - JN Learning Demonstration of the Epley Self-maneuver for a Right Posterior Canal Canalithiasis. https://edhub.ama-assn.org/jn-learning/video-player/18794333