Vertigo – Epley manoeuvre from BMJ Learning
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Vertigo – Epley manoeuvre from BMJ Learning


There are a number of treatments and a number
of manoeuvres to treat benign paroxysmal positional vertigo. However, the Epley manoeuvre is the
most well established and it is the test that has proven to be successful in this condition.
The first part of the Epley manoeuvre is essentially performing the Dix-Hallpike manoeuvre.
Once the head has been extended I always make
sure that if a patient is feeling dizzy or I see some nystagmus, I wait for this to completely
resolve before continuing to perform the next stage of the manoeuvre.
The head is turned 90 degrees towards the opposite shoulder. This means that the head
now lies 45 degrees relative to the vertical plane. You can relax your arms now. What Iíd
like you to do, in your own time, is to roll on to your left hand side and just let me
support your head. Whilst the patient is turning, the head is rotated a further 90 degrees in
the same direction. Finally, the patient is asked to sit up with
her legs over the side of the couch. During this manoeuvre I like to take control of the
head so that I can position it as I would like it to be. At the end of the manoeuvre
I ask the patient to finish so that their chin is sitting nicely on their chest.

49 Comments

  • Omar Nadeem

    I got into a high speed car accident a month ago, broke my arm and a massive abrasion on my forehead. Which caused BPPV, it was quite jarring until I did the Epley manoeuvre , and the dizziness is completely gone!! Definitely get it done!

  • I was Batman

    I just recently became sick with BPPV vertigo, can someone please tell me how long this lasts for ? I read it can go on for six Months !?

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  • Ann inGG

    The only thing different from his maneuver is a few other ones they do not look down after you have done at least for 24 hours and wrap towel or use neck brace. So I was surprised you did not leave her head in the turn position upright and have her looking down? Any thoughts on this. I've had extreme vertical I've had two fouls in the last two months doing stupid things in the bathtub and then tripping on my bedspread. So unbalanced at times I've been washing my hair in the sink with my head upside down and I think that might have finally caused the crystals to go even further out of place. I was afraid to do the Epley at home by myself so I found a Doctor Foster that has a half somersault maneuver. Cuz I have two bad knees like that on the toilet forward and put my head between my knees as far as I could. If I had any doubt it was the crystals in my ear ohmygod doing that brought back the extreme vertigo. Actually on both sides so I think both ears were affected. I waited 15 minutes and did it again and I didn't get dizzy. Still have a headache sore neck and lightheadedness but I'm hoping it'll go away if not I will go to the doctor's office and get the Epley maneuver done. Just looking for a feedback and thoughts for anyone else's experience

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    Is there a prophylactic benefit for an intermittent vertigo victim doing the Epley maneuver regularly, not just when suffering from vertigo?

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