Epley procedure/maneuver (canalith repositioning)
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Indications
- self treatment procedure for benign positional vertigo*
* has replaced Brandt-Daroff exercise as treatment of choice[3][4]
* see Dix-Hallpike maneuver for assessment of benign positional vertigo
Procedure
See[4][5][9] for depiction of the Epley maneuver
Left-sided vertigo:
- sit on a bed & turn your head 45 degrees to the left
- lie back quickly with a pillow under your shoulders & head reclined onto the bed
- wait 30 seconds
- turn your head 90 degrees to the right keeping it on the bed
- wait 30 seconds
- turn your body & head another 90 degrees to the right
- wait for 30 seconds
- sit up on the right side
Right-sided vertigo:
- sit on a bed & turn your head 45 degrees to the right
- lie back quickly with a pillow under your shoulders & head reclined onto the bed
- wait 30 seconds
- turn your head 90 degrees to the left keeping it on the bed
- wait 30 seconds
- turn your body & head another 90 degrees to the left
- wait for 30 seconds
- sit up on the left side
Total time in exercise should be about 10 minutes.
Mechanism of action
- the Epley maneuver designed to permit otolith debri originating in the utricle to pass through the semicircular canal & return to the utricle[3]
More general terms
Additional terms
- benign positional vertigo; benign paroxysmal positional vertigo
- Dix-Hallpike maneuver
- vestibular rehabilitation
References
- ↑ Journal Watch, Mass Med Soc 19(23):186 (Dec) 1999
- ↑ http://www.charite.de/ch/neuro/vertigo.html
- ↑ 3.0 3.1 3.2 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ 4.0 4.1 4.2 Journal Watch 24(17):136, 2004 Radtke A, von Brevern M, Tiel-Wilck K, Mainz-Perchalla A, Neuhauser H, Lempert T. Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure. Neurology. 2004 Jul 13;63(1):150-2. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15249626 <Internet> http://n.neurology.org/content/63/1/150.long
- ↑ 5.0 5.1 Video 4 min 30 sec Web-Guided Canalith Reposition Maneuver JAMA Neurology. 2023. Jan 17 https://edhub.ama-assn.org/jn-learning/video-player/18751089
- ↑ Johns Hopkins Health Home Epley Maneuver https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/home-epley-maneuver
- ↑ Vertigo - Epley manoeuvre from BMJ Learning https://www.youtube.com/watch?v=jBzID5nVQjk
- ↑ Epley Maneuver: Performed on a Real Patient suffering from Vertigo https://www.youtube.com/watch?v=K4S4CbuN6QA
- ↑ 9.0 9.1 Strupp M, Mandala M, Vinck AS et al The Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo. A Randomized Clinical Study. JAMA Neurol. 2023;80(8):798-804 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37358870 PMCID: PMC10425825 Free PMC article https://jamanetwork.com/journals/jamaneurology/fullarticle/2806601
JN Learning Demonstration of the Epley Self-maneuver for a Right Posterior Canal Canalithiasis. https://edhub.ama-assn.org/jn-learning/video-player/18794333