Epley Maneuver

What Is Epley Maneuver?

Epley maneuver refers to a sequence of movements conducted on the head to treat benign positional vertigo. Benign positional vertigo or benign paroxysmal positional vertigo (BPPV) is an abrupt feeling that you are spinning or the inside of your head is rotating.

Benign paroxysmal positional vertigo (BPPV happens when you have a problem with your inner ear. It is caused when little deposits of small bones called canaliths break and float inside the canals of your inner ear. This disrupts the flow of message to the brain creating confusion about your body’s position hence causing benign paroxysmal positional vertigo (BPPV).

Benign paroxysmal positional vertigo (BPPV) is more common in people who are more than 50 years of age, but all ages are affected. It is more prevalent in women than men.

Epley maneuver procedure is conducted to remove the canaliths floating in the canal so as to stop the symptoms or vertigo that a person experiences when the small calcium deposits remain there. ¹

Symptoms

The signs and symptoms of benign positional vertigo include

Nausea
Vomiting
Dizziness
Balance loss or unsteady balance
Feeling of your head spinning or moving

These symptoms of benign paroxysmal positional vertigo can last less than one minute. However its occurrence is usually recurrent; it disappears for sometimes and then recurs.

Causes

There are various activities that can cause benign paroxysmal positional vertigo (BPPV) but vary from one person to another. Activities that can change the position of your head usually cause benign paroxysmal positional vertigo (BPPV).You can feel dizzy when you change your head position; turn your head up and down, turn and sit on the bed or lie down. Some people can loss balance when they are walking or standing.

Nystagmus

These refer to abnormal, fast and uncontrollable eye movements’ .These movements can be side to side (horizontal), up and down (vertical) or rotational. Spontaneous eye movements are caused by unusual function of regions in the brain that control your eye movements. This also affects the labyrinth, the inner part of your ear to sense eye movements.

Nystagmus can result from inherited eye disorders although this is very rare. Drugs and medications such as Phenytoin and consuming too much alcohol can impair labyrinth function leading to Nystagmus.

Other causes

Labyrinthitis, a disorder of the inner ear.
A head injury
Stroke
Lack of Thiamine, Thiamine is Vitamin B 1used to treat brain damage called cerebellar syndrome.

When to See The Doctor?

See your doctor immediately if you feel dizzy and accompanied with any of the following symptoms:

Loss of vision
Loss of hearing
Difficulty in walking
Trouble to speak
High body temperature, Fever
Acute headache
Weakness in your leg or arm.

How to Prepare For The Procedure?

Before you make an official appointment to see your doctor, do the following:

Use a notebook to write all the symptoms you have been experiencing. Remember to include the dates you started experiencing these symptoms and how often they repeat.
Remember and note all injuries including minor accidents to your head.
Compile a list of your medical history by writing all the information about the diseases and condition you have been or being treated for. Include also the medicines or any other supplements you are using for treatment.

This information will help your doctor make informed decisions on whether to conduct this procedure or not .Your doctor cannot conduct this procedure on you if have a spine problem or had a recent neck injury. In case your symptoms are very acute, your doctor will prescribe some medication for you to minimize anxiety and nausea.

How is Epley Maneuver is Performed?

You can do Epley maneuver at home or seek for a health professional help. The following are steps you can follow to perform Epley maneuver by yourself.

Step 1

Sit on the bed with your legs flat on the bed in front of you. Then rotate your head to the affected side.

Step 2

Lie down on you back with the head in the same position. At this point, you may experience intense symptoms of vertigo.

Step 3

Move your head towards the opposite side.

Step 4

Turn your body so that it is facing the same direction as your head. You can do this by rolling over on your other side so that your body and head are facing to the side.

Step 5

Then sit up

You may need to repeat these steps for several times to effectively treat the symptoms.

What should I do to Succeed In Epley Maneuver Exercises?

If you have never done Epley maneuver exercises, consult your doctor to avoid doing the wrong exercise. You doctor will show you the right way of doing the Epley maneuver.

Risk Factors

During Epley maneuver, you can experience the following:

Nausea and vomiting
Intense vertigo symptoms

What to Consider After Epley Maneuver?

When you finish conducting Epley Maneuver exercises, avoid the following that could worsen the situation:

Do not bend over
Do not sleep on the affected side because this could aggravate the symptoms.

What Next if you Still Feel Dizzy After Exercise?

If you experience dizziness after doing Epley maneuver at home, visit your doctor immediately. Your doctor will determine if you are doing correct exercises or discuss other treatment options. Some of the treatment options include:

Canalith maneuvers

Your doctor will conduct on you a series of specific head and body movements to remove calcium deposits from the canal to the other part of the inner ear.

Motion sickness medications

Your doctor will prescribe the following Motion sickness medications.

Scopolamine

This drug is used to relieve you from motion sickness symptoms such as nausea. This drug should be used at least 30 minutes before you have been exposed to motion exercises. The drug is place placed behind your ear on a clean hairless region.

Perform other tests

Your doctor will conduct tests to find out other problems causing dizziness. The doctor will determine whether you have the following:

Ear infections

An ear infection is caused by bacteria or virus which affects your middle ear, the part of your ear behind the eardrum. This leads to swelling or blockage of one of your Eustachian tubes that causes fluids to accumulate in your middle ear. Your doctor will conduct a physical examination on your ear by using an instrument called otoscope. If no cause has been found, your doctor will conduct further tests such as analyzing a sample of fluid in your ear to find out if bacteria are present.

The Epley maneuver is considered a safe procedure though it can lead to mild effects like short term dizziness and feeling of nausea. While the procedure may be successful, it is likely that BPPV can return again. When that happens, the procedure can be repeated and it doesn’t take long. It can be safely performed in the office of a doctor, for example. ⁷

References

Epley maneuver. https://medlineplus.gov/ency/article/007662.htm
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025000/
Benign Paroxysmal Positional Vertigo (BPPV). https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022338/
http://www.mayoclinic.org/diseases-conditions/vertigo/basics/definition/con-20028216
Epley maneuver. http://keckmedicine.adam.com/content.aspx?productId=117&pid=1&gid=007662
Ear infections. http://www.healthline.com/health/ear-infections?m=2#Overview1.
Positional vertigo: Can the Epley maneuver help against sudden attacks of dizziness?. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072679/