Epley procedure/maneuver (canalith repositioning)

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Indications

* 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

More general terms

Additional terms

References

  1. Journal Watch, Mass Med Soc 19(23):186 (Dec) 1999
  2. http://www.charite.de/ch/neuro/vertigo.html
  3. 3.0 3.1 3.2 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. 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. 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
  6. Johns Hopkins Health Home Epley Maneuver https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/home-epley-maneuver
  7. Vertigo - Epley manoeuvre from BMJ Learning https://www.youtube.com/watch?v=jBzID5nVQjk
  8. Epley Maneuver: Performed on a Real Patient suffering from Vertigo https://www.youtube.com/watch?v=K4S4CbuN6QA
  9. 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