Unpredictable and intense dizzy spells are alarming, incredibly inconvenient and sometimes dangerous, especially those that occur while driving. Benign paroxysmal positional vertigo (BPPV) causes most episodic dizziness. It occurs when the sand-sized inner ear particles of calcium carbonate, called canaliths or otoconia, loosen and move about in the ear canal. Canalith repositioning exercises such as the Epley manoeuvre restore the loose otoconia in their proper place and are a free and highly effective method for the relief of BPPV. The first time you do the Epley manoeuvre, make sure it is in a doctor's office; repeat later as needed at home. It is not necessary to restrict your posture after performing the Epley manoeuvre unless your vertigo increases.
Identify the affected ear by consulting a medical practitioner to ensure you start the Epley manoeuvre on the correct side.
Sit upright in the centre of the bed with legs extended. Place a pillow horizontally directly behind your back. Turn your head 45 degrees toward the symptomatic ear. This may trigger some momentary dizziness.
Keep your head turned to the side, and lie down. Your back and shoulders will rest on the pillow, and your head will tilt back to rest on the bed. Remain this way for 30 to 60 seconds, breathing naturally. More transient vertigo may occur when you lie down.
Turn your head to the opposite side while lying on the pillow. Stay in place for 30 seconds, breathing comfortably. Turning the head may provoke yet another dizzy spell.
Roll onto your side, so your body and your head lie in the same direction, and bracing yourself with your top hand, roll forward slightly so you can turn your face toward the floor. Remain in this position for 30 seconds to 60 seconds, breathing easily. Another dizzy spell may occur.
Swing your legs and feet over the side of the bed and sit upright. Keeping your head straight, tuck your chin in 45 degrees. Remain in place for 60 seconds, breathing comfortably.
Do the Epley manoeuvre before going to bed because it may cause fatigue.
Seek medical attention immediately if you experience headaches, vision changes, physical weakness or loss of sensation after performing the Epley manoeuvre. Performing the Epley at home is likely to trigger vertigo or dizziness briefly before the ear particles reposition correctly.
Tips and warnings
- Do the Epley manoeuvre before going to bed because it may cause fatigue.
- Seek medical attention immediately if you experience headaches, vision changes, physical weakness or loss of sensation after performing the Epley manoeuvre.
- Performing the Epley at home is likely to trigger vertigo or dizziness briefly before the ear particles reposition correctly.
- Mayo Clinic: Canalith Repositioning Procedure: Definition
- Dizziness-and-Balance; Benign Paroxysmal Positional Vertigo; Timothy C. Hain, MD; February 17, 2011
- "Auris Nasus Larynx"; Are postural restrictions after an Epley manoeuvre unnecessary? First results of a controlled study and review of the literature; Georgios Fyrmpas, Demitrios Rachovitsas, Anna Bettina Haidich, Jiannis Constantinidis, Stefanos Triardus, Victor Vital, Meltiadid Tsalighopoulos; December 6, 2009
- Neurology; Self-Treatment of benign paroxysmal positional vertigo: Video 2