The Ear and Balance Center: The Epley Maneuver for BPPV

Patients with vertigo should seek medical care.  This instruction is designed for those diagnosed with BPPV by a physician, should they require repetition of the maneuver at home.

 

Helpful Hints:

Have someone guide you. If you become dizzy you may move out of the proper position without realizing it.

Hanging the head backward by placing pillows under the shoulders is critical for success.

If arthritis or neck stiffness prevents you from the motion required; or if you have discomfort or pain in the neck, back or elsewhere, stop. The maneuver can be done with in the office or with a vestibular therapist who can help support you through the procedure without injury.

Check both sides with steps 1 and 2 to determine which ear is involved.  If both sides are involved, treat the worse ear first, and wait a few days before doing the maneuver on the other side.

 

THE MANEUVER FOR
BPPV IN THE RIGHT EAR

1. Sit on the side of a bed with your head turned 45° to the right, and 3 or 4 pillows behind you.
2. Lay back keeping your head turned. The pillows should now be under your shoulders, and your head should hang onto the bed. (This movement will trigger vertigo, especially if you move quickly. You can do this later, to test whether your BPPV is gone.)
3. Slowly turn your head as far to the left as you can without discomfort. This should take 2 or 3 minutes.
4. Roll your body to the left, turning your head until you are flat on the bed with your face aimed directly down.
5. Slowly raise your head and body until your are kneeling upright with your head aimed straight ahead. The entire maneuver should take about 4 or 5 minutes. You may have vertigo near the end of the maneuver.

THE MANEUVER FOR
BPPV IN THE LEFT EAR

1. Sit on the side of a bed with your head turned 45° to the left, and 3 or 4 pillows behind you.
2. Lay back keeping your head turned. The pillows should now be under your shoulders, and your head should hang onto the bed. (This movement will trigger vertigo, especially if you move quickly. You can do this later, to test whether your BPPV is gone.)
3. Slowly turn your head as far to the right as you can without discomfort. This should take 2 or 3 minutes.
4. Roll your body to the right, turning your head until you are flat on the bed with your face aimed directly down.
5. Slowly raise your head and body until your are kneeling upright with your head aimed straight ahead. The entire maneuver should take about 4 or 5 minutes. You may have vertigo near the end of the maneuver.