The Epley maneuver is performed when a person suffers from benign paroxysmal positional vertigo (BPPV). This syndrome is triggered when the crystals inside the ear (called otoliths) move from their location (utricle) towards the back and inside of the ear canal (semicircular canals). This maneuver repositions the crystals and relieves symptoms. It is important that the first time it is performed by a doctor (this aspect will be dealt with in the first part of the article). You will then be given instructions, again by the doctor, on how to do it at home and if "self-treatment" is indicated in your situation. In some cases it is not advisable to do the Epley maneuver on your own and you will need to take a rest period instead. Note: this article explains how to perform an Epley maneuver to reposition the otoliths of the right ear. You have to do the exact opposite if your BPPV arises from the left ear.
Steps
Part 1 of 3: Undergo the Maneuver Performed by a Doctor
Step 1. Make an appointment with your doctor if this is your first time undergoing the Epley maneuver
If you suffer from vertigo and have recently been diagnosed with BPPV, then the doctor must reposition the crystals. A doctor or a specialized physiotherapist are the only ones who should undergo the treatment if you have never undergone it before. However, you will be taught how to do it yourself in case the symptoms recur in the future.
Step 2. Know that it is very important to rely on a professional
Although it is a procedure that can also be done at home, a doctor's guidance will allow you to understand what you need to feel when the maneuver is performed correctly. Trying blindly could dislodge the otoliths even further and cause dizziness to worsen!
If you already know how you should feel when the maneuver is performed well, you can directly read the second part of the article to refresh your memory
Step 3. Be prepared to feel dizzy during the first phase of the maneuver
Your doctor will make you sit on the edge of the table or bed with your face facing forward. He will place one hand on each side of his face and quickly move it 45 ° to the right. It will instantly make you lie down, while keeping your head in the same position. It will now ask you to stand still for 30 seconds.
Your boss should be over the edge of the bed or, if you have a pillow under your back, it will be resting on the bed. Regardless of where the head is placed, the goal is to keep it at a lower level than the rest of the body
Step 4. The doctor will rotate your head again
While you are lying down, he will move to rotate your head 90 degrees to the opposite side (i.e. to the left).
You need to pay attention to any dizzy feelings you may experience. It should stop 30 seconds after assuming the new position
Step 5. Roll onto your side
At this point the doctor will ask you to place yourself on your left side while quickly turning your head to the left so that your nose is pointed down. To understand what is happening, imagine that you are in your bed, resting on your left side but with your face on the pillow. It will keep you in this position for another 30 seconds.
Check the side of rotation and the direction of the nose well. Note that if the doctor determines that the problem is on the right side, he will turn your body and head to the left, and vice versa
Step 6. Return to a sitting position
After 30 seconds the doctor will quickly get you up and down. You should no longer feel dizzy, but if this happens, the maneuver must be repeated until the symptoms disappear. Sometimes several maneuvers are required to bring the crystals back into place.
To treat the BPPV of the left ear, the same procedure is performed, but on the other side
Step 7. Give yourself time to heal after undergoing the Epley maneuver
It will be necessary to apply a soft collar for the rest of the day. Your doctor will also instruct you on how to sleep and what movements to do so that you don't feel dizzy again. If you are not given any instructions to perform the maneuver independently, go to section 3 of the article.
Part 2 of 3: Perform the Maneuver alone
Step 1. Know when to perform the maneuver at home
You should only do it if your doctor has specifically diagnosed you with BPPV; if there is the possibility that your dizziness has another origin, then this procedure should only be performed by the doctor. The maneuver performed at home is, more or less, the same one you underwent in the clinic, but with some adjustments. Your doctor should have explained all the steps to you, but the description below explains what you should do.
You should not perform the Epley maneuver if you have recently suffered a neck injury, if your neck motility is limited, or if you have a history of stroke
Step 2. Put the pillow in the right position
It must be on the bed in such a way that when you lie down it is under your back so that your head stays lower than the rest of your body. Sit on the edge of the bed and turn your head 45 degrees to the right.
If possible, get someone to assist you. It might be helpful to have a person take the time when you have to stand still for 30 seconds
Step 3. Lie down with a sudden movement
The head must remain turned 45 ° to the right, and the pillow under the shoulders will allow you to have the head lower than the body. The head should rest on the bed. Stay like that for 30 seconds.
Step 4. Turn the garment 90 degrees to the left
While lying down, quickly turn your head 90 degrees to the opposite side. Do not lift your head while turning it, otherwise you will have to repeat everything from the beginning. Rest in this position for 30 seconds.
Step 5. Rotate the whole body onto the left side (head included)
From the position you are in, turn around so that you are resting on your left side. The face should look down and the nose touch the bed. Remember that the head is more rotated than the body.
Step 6. Hold this last position and then return to your seat
Wait 30 seconds lying on your left side with your nose touching the bed. After this time, return to a sitting position. You can repeat the procedure 3-4 times until the dizziness disappears. If BPPV originates from the left ear, perform all the same movements on the opposite side.
Step 7. Choose to perform the maneuver before bedtime
Especially if it is the first time you are performing the Epley maneuver on yourself, the ideal to do well is to do it before bed. That way, if something goes wrong and you inadvertently feel dizzy or dizzy, you can immediately move on to sleep (without negatively impacting your day).
After practicing the maneuver and becoming familiar with doing it on yourself, feel free to perform it at any time during the day
Part 3 of 3: Healing After the Maneuver
Step 1. Wait 10 minutes before leaving the doctor's office
It is important to wait for the crystals in the inner ear to settle before inadvertently fidgeting again. This helps you avoid any rebound symptoms of vertigo right after you leave the doctor's office (or right after performing the maneuver on yourself).
After about 10 minutes the crystals should be fine and you can proceed with your day as usual
Step 2. Wear a soft collar for the rest of the day
When your doctor undergoes the procedure, he will prescribe this brace for you throughout the day. It will help you control your movements so you don't accidentally rotate your head and dislodge the otoliths again.
Step 3. Sleep with your head and shoulders elevated
The night following the treatment you should sleep with your head and upper body raised 45 degrees. You can use pillows or choose to sleep on a reclining deck chair.
Step 4. Try to keep your head vertical as much as possible during the day, with your face facing forward
Avoid going to the dentist, the hairdresser or engaging in activities that make you tilt your head back. Also avoid exercises where you have to move your head a lot. It should never recline more than 30 °.
- When you take a shower, put your head right under the jet of water so as not to be forced to recline your head.
- If you are a man and need to shave, lean your body forward instead of tilting your head to shave.
- Avoid any other postures that may stimulate BPPV for at least a week after you have been given the Epley maneuver.
Step 5. Check the results
After waiting a full week to avoid the symptoms that are known to cause your BPPV, try an experiment and see if you can feel dizzy again (assuming one of the positions that may have previously caused it). If the maneuver was successful, you shouldn't be able to trigger dizziness in yourself right now. They may return sooner or later, but the Epley maneuver is very successful and serves as a temporary cure for BPPV in about 90% of people.
Advice
- Before performing the maneuver, have a doctor show you how to do it.
- Keep your head lower than your body when performing this procedure.
- Some doctors recommend doing this maneuver just before going to bed and then raising your head when you go to sleep.
Warnings
- Be gentle with yourself, do not move too quickly so as not to hurt your neck.
- Stop if you experience headaches, vision disturbances, weakness or numbness.
