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Epley Manoeuvre (Treatment for BPPV)

The most effective treatment for benign paroxysmal positional vertigo.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Epley Manoeuvre (Treatment for BPPV)?

Described by John Epley in 1992, the Epley manoeuvre is a canalith-repositioning procedure that returns otolith (canalith) particles from the posterior semicircular canal to the utricle. It is the most common and effective treatment for benign paroxysmal positional vertigo (BPPV).

The manoeuvre proceeds through five positions: from sitting with the head turned toward the affected side, the patient is tilted back onto the bed, turned toward the opposite side with head down, then brought back up. Each position is held for 30–60 seconds.

Success is about 80% with a single treatment and up to 95% with repeat sessions. After treatment, the patient should keep the head elevated for 24–48 hours, sleep upright and avoid abrupt head movements.

Symptoms

Short-lived vertigo triggered by a change in head position
Dizziness when getting into or out of bed
Lightheadedness when looking up
Bouts of nausea and vomiting
Sense of imbalance
Vertigo episodes shorter than 30 seconds

Risk Factors

Age over 60
Female sex
Head trauma
Previous ear surgery
Prolonged bed rest
Previous vestibular neuritis

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For vertigo triggered by head position
  • For a positive Dix–Hallpike test
  • For recurrent BPPV episodes
  • If the first Epley has failed
  • For atypical nystagmus patterns

Treatment Methods

01
Confirm diagnosis with the Dix–Hallpike test
02
Identify the affected side
03
Perform the Epley manoeuvre (five positions)
04
Hold each position for 30–60 seconds
05
Keep the head elevated for 24–48 hours afterwards
06
Home exercise programme
07
Semont manoeuvre as alternative if Epley fails
08
Surgery (occlusion) for refractory cases

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.