Treating BPPV: The Epley Manuever – Boys Town National Research Hospital


BPPV stands for Benign Paroxysmal Positional
Vertigo and essentially with BPPV, crystals from the ear get dislodged and displaced into
a different part of the inner ear. The treatment for that is to put the head in different positions
to move those crystals back into the part of the ear that they belong. As soon as those
crystals get back into that part of the ear, patient’s symptoms improve dramatically.
If you are treating right BPPV you are going to turn your head over your right shoulder
and then you are going to lay flat on your back. Your head is going to fall just below
the level of your shoulders. If you are doing this at home you can put a pillow behind your
shoulders and have your head resting and supported on the bed.
In this position you will wait for any symptoms to subside and then wait an additional thirty
seconds. Next you’ll want to move your head from looking over your right shoulder to looking
over your left shoulder without picking your head up. Again in this position you’ll want
to wait for any symptoms to go away and then wait an additional thirty seconds.
For the next position you’ll keep your chin looking over your left shoulder and you’ll
roll up onto your left side. Now you should be looking down at the floor. Again wait for
any symptoms to go away and then wait an additional thirty seconds. Lastly kick your feet out
to the front and use your right hand to push yourself up to the seated position. When you
are finished, wait for a couple of minutes until all symptoms go away.
For left sided BPPV you are going to turn your head over your left shoulder and lay
flat on your back. Once on your back your head should be below the level of your shoulders.
If doing this at home you can put a pillow underneath your shoulders with your head supported
by the bed. In this position you’ll want to wait until all symptoms subside and then
wait an additional thirty seconds. Next you’ll want to turn your head from
looking over your left shoulder to your right shoulder without picking your head up. Again
you’ll want to wait until all your symptoms go away and then wait an additional thirty
seconds. For the next movement you’ll want to keep looking over your right shoulder and
then roll up onto your right side. Once on your right side you should be looking down
at the floor. Again wait for all symptoms to go away and then wait an additional thirty
seconds. Then you’ll kick your legs out and using your left hand pick yourself up
into the sitting position and then look straight ahead, again waiting thirty seconds until
any symptoms go away. The maneuvers are typically done twice a day
until patients can go three consecutive days without experiencing any symptoms, so the
typical duration for most patients is to complete the exercises anywhere from three to seven
days.

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