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Treating BPPV: The Epley Manuever

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Treating BPPV: The Epley Manuever
Kristen Janky, Au.D., Ph.D., CCC-A, Vestibular Audiologist

BPPV stands for Benign Paroxysmal Positional Vertigo and essentially with BPPV, crystals from the ear get dislodged and displaced into a different part of the inner ear. The treatment for that is to put the head in different positions to move those crystals back into the part of the ear that they belong. As soon as those crystals get back into that part of the ear, patient’s symptoms improve dramatically.

If you are treating right BPPV you are going to turn your head over your right shoulder and then you are going to lay flat on your back. Your head is going to fall just below the level of your shoulders. If you are doing this at home you can put a pillow behind your shoulders and have your head resting and supported on the bed.

In this position you will wait for any symptoms to subside and then wait an additional thirty seconds. Next you’ll want to move your head from looking over your right shoulder to looking over your left shoulder without picking your head up. Again in this position you’ll want to wait for any symptoms to go away and then wait an additional thirty seconds.

For the next position you’ll keep your chin looking over your left shoulder and you’ll roll up onto your left side. Now you should be looking down at the floor. Again wait for any symptoms to go away and then wait an additional thirty seconds. Lastly kick your feet out to the front and use your right hand to push yourself up to the seated position. When you are finished, wait for a couple of minutes until all symptoms go away.

For left sided BPPV you are going to turn your head over your left shoulder and lay flat on your back. Once on your back your head should be below the level of your shoulders. If doing this at home you can put a pillow underneath your shoulders with your head supported by the bed. In this position you’ll want to wait until all symptoms subside and then wait an additional thirty seconds.

Next you’ll want to turn your head from looking over your left shoulder to your right shoulder without picking your head up. Again you’ll want to wait until all your symptoms go away and then wait an additional thirty seconds. For the next movement you’ll want to keep looking over your right shoulder and then roll up onto your right side. Once on your right side you should be looking down at the floor. Again wait for all symptoms to go away and then wait an additional thirty seconds. Then you’ll kick your legs out and using your left hand pick yourself up into the sitting position and then look straight ahead, again waiting thirty seconds until any symptoms go away.

The maneuvers are typically done twice a day until patients can go three consecutive days without experiencing any symptoms, so the typical duration for most patients is to complete the exercises anywhere from three to seven days.

Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo, a false sensation of spinning. Kristen Janky, Au.D, Ph.D., CCC-A​, Vestibular Audiologist at Boys Town National Research Hospital, demonstrates how to treat BPPV using the Epley Manuever.

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