#EPLEY'S MANEUVER VERTIGO SERIES#

The literature demonstrated beneficial effects of multiple treatment sessions for patients with persistent nystagmus following the initial maneuver. from the year 2010 showed that post maneuver restrictions are not necessary as they have not shown any significant benefit compared to no restrictions.

Afterward, bring the patient into the upright sitting position to complete the maneuver. Again, hold this position for 20-30 seconds. Afterward, have your patient roll onto his left shoulder and quickly turn his head a further 90 degrees so that his head is facing down at a 45° angle. Next, quickly turn your patient’s head 90 degrees toward the unaffected side and hold this position for another 20 seconds. Now take the patient backward in a quick movement so that your patient’s head is still rotated and extended to 20 degrees by the pillow. The steps are an exact mirror for the left side. So if your Dix-Hallpike test was positive in this position, this is how you start. Rotate your patient’s head 45 degrees to the right in order to perform the maneuver for the right posterior semicircular canal. To perform the modified Epley maneuver have your patient sit on the treatment bench in long-sit with a pillow on the table that will make sure that the patient’s head is extended to 20° in a second. On top of that, make sure that your patient is able to tolerate neck movement. The patient should be counseled that his symptoms of vertigo will be reproduced and that he might feel nauseous. So make sure you have a bucket at hand, in case your patient might need it. Be aware that the Epley maneuver can lead to nausea which was reported in 17-32% of patients. The chance of success in this review was described to be as high as 80%.

There was no difference when Epley was compared to the Semont maneuver. (2014), the authors found that the Epley maneuver was more effective than sham maneuvers or control.

#EPLEY'S MANEUVER VERTIGO SERIES#

The modified Epley maneuver involves a series of four movements of the head and body in order to move the debris out of the posterior semicircular canal. This causes movement of the cupula and bending of the hairs of the hair cells and provokes vertigo.Īround 20% of BPPV cases are said to resolve within 4 weeks and up to 50% up to 3 months without treatment, but recurrence is reported between 10-18% after 1 year. In canalithiasis, free-floating debris in the semicircular canal is hypothesized to act as a plunger, causing continuing movement of the endolymph even after head movement has ceased. The cause of BPPV is believed to be canalithiasis, affecting the posterior semicircular canal in 85 to 95% of all cases. Head movement causes relative movement of the endolymph in the semicircular canal, which bends the cupula and the embedded hairs of the hair cells and causes stimulation of the relevant vestibular nerve. The main sense organ in each canal is called the crista, which is stimulated by the movement of the cupula. The semicircular canals are filled with a fluid called endolymph. This causes ongoing movement that conflicts with other sensory information. BPPV can be caused by debris in the semicircular canal of the ear, which continues to move after the head has stopped moving. Common causes are head trauma or ear infections, although most cases appear to be idiopathic. Epley Maneuver | Posterior BPPV Treatment | Vertigo Treatmentīenign paroxysmal positional vertigo, abbreviated as BPPV is the most common inner ear problem and cause of vertigo, or a false sense of spinning.

Epley's maneuver vertigo