Content

• To step
• Method 1 of 3: Perform the maneuver at the doctor's
• Method 2 of 3: Perform the maneuver yourself
• Method 3 of 3: Recover after the maneuver
• Tips
• Warnings

The Epley maneuver is performed when someone is dizzy due to Benign paroxysmal positional vertigo (BPPD). BPPD occurs when crystals (called otoconia) detach from the inner ear and move from their proper place in the ear to the back of the lower internal auditory canal (the posterior semicircular canal). With the Epley maneuver, the loose crystals can be put back into place, relieving the symptoms of BPPD. It is important that you first perform the maneuver under the supervision of a doctor; he / she can then give instructions and tell you whether you can do the maneuver yourself at home. Your doctor may also be able to refer you to a physical therapist who can help you perform the Epley maneuver.

To step

Method 1 of 3: Perform the maneuver at the doctor's

1. Make an appointment with your doctor if you have never performed the Epley maneuver before. If you have vertigo and have recently been diagnosed with BPPD, see a doctor to perform the Epley maneuver to put the crystals in your inner ear back into place. The first time you have to do the maneuver under the guidance of a doctor or therapist. However, he / she can also teach you how to do it yourself, in case the complaints return.
2. Know why it is important to perform the maneuver under the guidance of a doctor first. While you can also do the maneuver at home (see Method 2 of this article), it's good to go through it with a doctor first so you know what it should feel like when you do it right. If you do it at home without knowing what to do, the crystals can actually go deeper into your ears, making the dizziness worse!
   • If you already know what this procedure should feel like when you're doing it right, you can move on to Method 2 to refresh your memory.
3. Be prepared for vertigo during the first step of the maneuver. The doctor will have you sit on the edge of a table or bed, facing forward. He / she then puts a hand on one side of your face and quickly tilts your head 45 degrees to the right. Afterward, your doctor will immediately have you lie on your back on the table, so that your head is still tilted 45 degrees to the right. You will have to remain in this position for 30 seconds.
   • Your head depends on the treatment table, or if you have a pillow under your back, your head rests on the table. The point is that your head is lower than the rest of your body when you lie down, which is where your head rests.
4. Prepare for the doctor to turn your head again. While you remain in the position your doctor just placed you in, he / she will move to a different position and quickly turn your head 90 degrees in the opposite direction (meaning your face is now turned to the left).
   • Pay close attention to whether you feel dizzy now. This is usually over after 30 seconds in this new position.
5. Roll onto your side. After this, the doctor will ask you to lie on your left side, your nose now pointing down. To visualize what to do, imagine that you are lying on your side in bed, but your face is in your pillow. You remain in this position for another 30 seconds.
   • Remember which way you are turned and where your nose is pointing. Note that the doctor will turn your body and head to the left if the problem is on the right side and vice versa.
6. Sit down again. After 30 seconds, the doctor will quickly lift you back up so that you are seated. Now you shouldn't feel dizzy anymore; if so, the maneuver can be repeated until the dizziness has disappeared. Sometimes the procedure has to be done several times to get all the crystals in place.
   • Please note that with BPPD the left hand side the procedure must be carried out the other way round.
7. Give yourself time to recover after the maneuver is complete. After your doctor's appointment, you may get a soft collar to wear for the rest of the day. Your doctor can also give you instructions on how to sleep and move so that the dizziness doesn't come back. These instructions can be found in Part 3 of this article.

Method 2 of 3: Perform the maneuver yourself

1. Know when to perform the maneuver at home. You can only do this maneuver yourself if your doctor has diagnosed BPPD. If there is a chance that the dizziness is caused by another condition, you should only perform the maneuver under the guidance of your doctor. The maneuver is almost the same at home as at the doctor, with some minor adjustments.
   • Don't do the Epley maneuver at home if you've recently had an injury to your neck, if you've had a previous stroke, or if you can't move your neck properly.
2. Put your pillow in the correct position. Place a pillow on your bed so that when you lie down, it is under your back, bringing your head lower than the rest of your body. Sit on your bed and tilt your head 45 degrees to the right.
   • Ask someone to stay with you while you perform the maneuver. It can be helpful if someone is around as you have to lie down for 30 seconds in each position.
3. Lie down quickly. Keep your head tilted 45 degrees to the right, and quickly lie down so that the pillow is under your shoulders and your head lower than your shoulders. Your head should rest on the bed. Keep your head turned 45 degrees to the right. Wait 30 seconds.
4. Turn your head 90 degrees to the left. While lying down, turn your head 90 degrees to the other side (left in this case). Don't lift your head while turning it; if you do, you may have to start over. Remain in this position for another 30 seconds.
5. Now turn your whole body (including your head) to the left. From the position where you are facing to the left, rotate your body further, so that you are now on your left side. Your face should be down so that your nose touches the bed. So remember that your head is turned further than your body.
6. Hold this last position and then sit down. Stay in this position for 30 seconds, on your left side with your face turned down so that your nose touches the bed. When the 30 seconds are up, sit down. You can repeat this maneuver 3 to 4 times a day until you are no longer dizzy. Remember, when you have BPPD on the other side, you have to do the same process the other way around.
7. Choose to perform the maneuver just before going to bed. It is best to perform the maneuver just before going to bed, especially if it is your first time doing it yourself. For example, if something goes wrong that makes you even more dizzy, you can go to sleep immediately (instead of negatively affecting your day).
   • Once you've mastered the maneuver, you can do it any time of the day.

Method 3 of 3: Recover after the maneuver

1. Wait 10 minutes before leaving the doctor. It is important to wait for the particles to settle in your inner ear or you will accidentally shake them back and forth. This will prevent your dizziness from returning before you leave the doctor's office (or immediately after you have performed the maneuver yourself at home).
   • After about 10 minutes the particles have settled again, and you can safely continue your day.
2. Wear a soft collar for the rest of the day. After performing the maneuver at the doctor's office, you may be given a soft collar (a neck collar) to wear for the rest of the day. This limits the movements of your head, so that the crystals stay in place.
3. Sleep with your head and shoulders upright as much as possible. Sleep the night after doing the maneuver you should sleep with your head up at a 45 degree angle. You can do this by putting some extra pillows under your head, or by sleeping in a lounger.
4. Keep your head as vertical as possible during the day. This means that you keep your neck as straight as possible, with your face forward. Do not go to the dentist or hairdresser, where you have to tilt your head back. Also, don't do exercises that require you to move your head a lot. Don't tilt your head more than 30 degrees.
   • When you shower, stand so that you are directly under the jet so you don't have to tilt your head back.
   • If you are a man and you need to shave, lean your body forward instead of tilting your head when you shave.
   • For at least a week after the maneuver, avoid other positions that you know cause BPPD.
5. Test the result. After a week of avoiding movements that can cause BPPD, do an experiment to see if you can induce the dizziness yourself (by adopting a position that previously made you dizzy). If the maneuver was successful, you shouldn't get dizzy now. It may eventually come back, but the Epley maneuver is very effective and can temporarily remedy BPPV in about 90% of people.

Tips

• Perform the maneuver under the guidance of a doctor before attempting it yourself.
• Always keep your head lower than the rest of your body when performing this procedure.

Warnings

• Stop the procedure if you develop a headache, if your vision changes, if you experience numbness or if you feel faint.
• Be careful - don't move so fast that you hurt your neck.