13 October 2022
Key points
- Benign paroxysmal positional vertigo (BPPV) is caused by trapped calcium crystals that affect the bodies balance organs, resulting in dizziness.
- The home Epley manoeuvre is a safe treatment for vertigo caused by BPPV. Its regular use makes it a better alternative to the one-off procedure used in clinic.
What is the Epley manoeuvre?
The Epley manoeuvre was introduced in 1980 by John Epley as a less invasive method to treat the symptoms of BPPV.
The organ responsible for balance is located inside your ear. It consists of semi-circular canals which act like a gyro to detect motion. In BPPV, calcium crystals can be dislodged from elsewhere and enter the semi-circular canals. Simple head motions cause movement of these crystals. These interfere with motion signals sent to the brain triggering brief episodes of vertigo.
The Epley manoeuvre involves a series of head movements to push these crystals out of the semi-circular canals to improve symptoms.
Why would I need to do the Epley manoeuvre?
In most cases the reason for developing BPPV is unknown. But it can occur if you’ve suffered a blow to the head or if you’ve had surgery in the ear.
What are the risks of doing Epley manoeuvre?
Whilst the Epley manoeuvre itself is quite safe, you may feel your dizziness getting worse during the exercise. For this reason, you may find it reassuring to have someone with you in the room. You should also avoid driving while you still feel dizzy.
The Epley manoeuvre may need to be avoided in patients who have certain problems with their neck, heart, joints, and eyes. Ask your healthcare professional to confirm if the exercises are safe for you.
What happens before the Epley manoeuvre?
These are best done at night on a bed as they can make you feel dizzy afterwards. Dress comfortably with a non-constricting collar and have a pillow handy to place under your shoulders. This is to allow easier neck movements.
What should I expect after the Epley manoeuvre?
Sit upright for the rest of the day and avoid sleeping on the affected side for the next few days. This is to prevent re-entry of crystals into the semi-circular canals. Half of people find their dizziness improves after just one manoeuvre. While others may need to repeat these daily for weeks.
What if my symptoms don’t improve?
If your symptoms don’t improve after 4 weeks, please contact your healthcare professional to exclude other causes.
Will the Epley manoeuvre cure my BPPV?
Although the Epley manoeuvre is effective at treating vertigo from BPPV, there is still a chance the symptoms may return weeks or even years later. This can be due to another crystal getting trapped in the semi-circular canals.