The Epley Maneuvers

of conservative treatment which involve exercises and a treatment that involves surgery are described in the next sections OFFICE TREATMENT OF BPPV The Epley and Semont Maneuvers There are two treatments of BPPV that are usually performed in the doctor s office Both treatments are very effective with roughly an 80 cure rate according to a study by Herdman

If you have just been diagnosed with benign positional vertigo then your physician or physiotherapist may need to perform some special exercises with you; these are known as the Epley maneuvers. Before explaining what happens during these exercises it will probably be best to first explain what they are meant to achieve.

Benign positional vertigo occurs because small crystals that normally live harmlessly in your ear have somehow become dislodged and are now interfering with your brain’s ability to deal with balance and body position. Within your inner ear is a complex known as the labyrinth and this contains fluid as well as nerve receptors that detect changes in this fluid. Any movement that you perform will cause the fluid to move and the nerve receptors will pick this up and send the signal to the part of your brain that is responsible for balance and working out your position. If crystals end up in this fluid they can cause disruption leading to faulty signals be sent by the receptors and causing you to experience vertigo. It is the aim of the Epley maneuvers to move the tiny crystals away from where they are causing mischief. Vestibular system and what is vertigo

The doctor will begin by asking you to sit facing forward and in an upright position. Your doctor will support your head while lowering you down onto the bed and turning your head at a 45 degree angle. You will be expected to hold this position for about a minute; it can be a bit unpleasant because this can trigger the vertigo sensations. You may start to feel nausea, swimming vision, spinning sensation, and pressure in head, but these will pass when the test is finished. The doctor will be observing for any uncontrolled eye movements called nystagamus. The doctor will then turn your head to the other side and hold for another minute. You will need to go through this procedure twice, before go back to the sitting position which you will hold for about a minute.

As well as the Epley maneuvers there are also some other exercises that the doctor or physiotherapist might try. The Semonth maneuvers involve quickly moving you from lying on one side to lying on the other. This is not often practiced so much in the United States because the movements are so brisk, but it is claimed to be as effective as the Epley maneuvers. The Gans maneuver is a combination of these two other exercises; there is still not enough evidence to support any firm conclusions about the effectiveness of this yet.

It is very important that these Epley maneuvers, or indeed the other maneuvers, are only ever carried out by a trained medical professional; either your doctor or a physiotherapist. It is possible to do some damage if this procedure isn’t conducted correctly. Never be tempted to try and do this yourself. These procedures can really help improve the situation for those with benign positional vertigo, but only if they are carried out by competent people.

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