Diseases and Disorders of the Ear - Epley Maneuver for BPPV or B.P.P.V

Epley Maneuver for BPPV

The following maneuvers are done in a physician or other therapists' office to alleviate the symptoms of BPPV. You can also do a modified version of these at home using the Brandt-Daroff variant.

These maneuvers are effective in about 80 percent of patients with BPPV. If an exercise works but symptoms recur or the response is only partial, try going through another set of the exercises for another week.

For the treatment of right-sided disease (reverse head position for left-sided disease):

Patient is positioned on bed with head slightly extended and turned 45 degrees to right.
Patient is positioned with head over a pillow placed at shoulder level and wait 1 minute.
Head is turned through 90 degrees and wait another minute.
Head is turned through a further 90 degrees, while patient rolls on to left side and wait another minute.
Patient sits up slowly. Wait 10-15 minutes before patient is sent home.

Epley Maneuver After Office Visit - Instructions

Do not drive home yourself; have someone else drive you.

Sleep semi-recumbent for the next two nights. This means sleep with your head halfway between being flat and upright (a 45 degree angle). This is most easily done by using a recliner chair or by using pillows arranged on a couch.

During the day, try to keep your head vertical i.e. eyes looking straight ahead. No sudden head turns to the right, left, up, or down.

Don't go to the hairdresser or dentist as they require head-turning.

No going to the gym or performing any exercise that requires head movement i.e. no sit-ups etc. You can swim, but only using the breast stroke where the head is level.

No vacuuming or mopping the floor! (If you are the lady of the house this is great news!)

Men: No shaving under the chin the normal way - stand away from the mirror and sink and bend your body forward keeping your eyes looking straight ahead.

Be very careful if you need to use eye-drops. Try to put them in without tilting the head back.

Shampoo only under the shower, again, looking straight ahead.

Try not to wear any sweater or pull-over that requires you to pull the clothing over the head.

Don't bend down to tie your shoes.

Sleeping: If the BPPV is affecting only once side of your head, then sleep on the opposite side. Before you drop off to sleep, tell yourself not to roll over (the subconscious will actually remember this instruction when you sleep.)

At one week after treatment, put yourself in the position that usually makes you dizzy. Position yourself cautiously and under conditions in which you cannot fall or hurt yourself. Keep track of your dizziness, if any. Let your doctor know how you did.

If you have tried both maneuvers (Epley and Brandt-Daroff) for two weeks and you still have dizziness symptoms, then surgery called posterior canal plugging might be an option.