The Epley Maneuver

Epley Maneuver

The Epley Maneuver is used to treat vertigo caused by the disorder paroxysmal positional vertigo (BPPV).

  • Beningn – it is not life-threatening
  • Paroxysmal – it come in sudden, brief spells
  • Positional – it gets triggered by certain head positions or movements
  • Vertigo – a false sense of rotational movement

Otoconia, or calcium deposits deep in the ear, are thought to be the cause of BPPV. BPPV typically only occurs in one ear at a given time. Most often, otoconia exists in two parts of the ear: the utricle and the sacculem. When enough otoconia accumulate in one of the canals they interfere with the normal fluid movement that the canals utilize to sense head motion, thus causing the inner ear to sense false signals to the brain about head motion. This is because fluid in the semi-circular canals do not typically react to gravity , but otoconia do react to gravity, thus moving the fluid when it would normally stay still.

Balance-Disorders-FS-Balance-SystemDiagnosis of BPPV involves the Dix-Halpike test, with a success rate of 90 to 95 percent. The Epley Maneuver repositions the otoconia that are in the inner ear to a different area of the ear by use of gravity and shifting positions. The relocation of otoconia places them where they will not cause symptoms. A physician, medical doctor, occupational therapist, audiologist, chiropractor, or a physical therapist must perform the Epley maneuver. The entire procedure only lasts an average of 15 minutes to complete, and it involves four unique head positions that are held in place for around 30 seconds each.

After the Epley Maneuver treatment, the patient is often given a soft collar that is to be worn for the rest of the day. The patient is also advised not to move in certain positions for the rest of the day that may affect their head. The soft collar is removed when the patient goes to sleep.

The Epley Manuever seems to be effective as a long-term treatment of BPPV with a limited number of complications, making it a treatment that is tolerated well by patients.

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