Repositioning Services (Epley)

Benign paroxysmal positional vertigo, or BPPV, is one of the most common causes of vertigo for patients in Pennsylvania and throughout the U.S. It is responsible for about half of all reported vertigo cases. While any episode of vertigo can be unsettling, repositioning services such as the Epley maneuver – a simple, painless procedure that can be done in the comfort of your home – are usually successful in curing patients of BPPV.

BPPV is the result of tiny calcium deposits called canaliths on the otolithic membrane of your inner ear becoming dislodged. Any movement of your head, however slight, causes these particles to drift into the fluid-filled cochlea. This leads to intense episodes of dizziness and vertigo.

The Epley Maneuver

Treatment for BPPV is straightforward and generally effective. The loose calcium particles need only be redistributed from the cochlea to another part of the ear where they will not cause dizziness or vertigo. The canalith repositioning maneuver – usually referred to as the Epley maneuver after its inventor, Dr. John Epley – is highly effective, with a success rate of about 95%.

To perform the Epley maneuver, the patient’s body and head are moved into a series of different positions for about 30 seconds at a time. Under the influence of gravity, the canaliths are forced into different areas of the semicircular canal, where they are unlikely to cause problems.

The sequence of positions is as follows:

  1. The patient begins seated in an upright position, the legs extended and the head rotated at a 45-degree angle.
  2. The patient is forced backwards into a supine position with the head held in a 30-degree neck extension. The physician checks the patient’s eyes for signs of nystagmus (involuntary eye movement).
  3. The patient remains in this position for 1-2 minutes.
  4. The patient’s head is rotated 90 degrees in the opposite direction while maintaining the 30-degree neck extension.
  5. The patient remains in this position for 1-2 minutes.
  6. The patient rolls onto his or her shoulder, rotating the head another 90 degrees in the direction they are facing. The eyes are again checked for nystagmus.
  7. The patient remains in this position for 1-2 minutes.
  8. The patient is slowly returned to an upright seated position while maintaining the 45-degree rotation of the head.
  9. The patient remains in this position for 30 seconds.

This procedure may be performed up to three times, or until the desired result is achieved. The Epley maneuver can also be performed at home for up to one week. Any of the experienced audiologists at ASK Physicians Hearing Centers can walk you through the simple steps.