The Epley maneuver is a series of head movements that restores equilibrium of the vestibular system and relieves symptoms of benign positional vertigo (BPV). BPV is caused by disturbances of the vestibular system in the inner ear when crystals of calcium carbonate clog the semicircular canals and sensory receptors send mixed signals to the brain about the body’s position. There are four major steps that make up the Epley maneuver.
For the first step, you will sit on an exam table with your legs extended. The doctor will turn your head 45 degrees in the direction of the ear that is causing BPV. Keeping your head in place, the doctor will tell you to lie back until your shoulders are resting on the table. Your head, however, will hang over the edge with the affected ear facing the floor. You will remain in this position for 30 seconds or until symptoms of BPV cease.
Second, without changing your elevation, the doctor will turn your head to a 45-degree angle in the opposite direction so that your affected ear faces the ceiling. On this side, the doctor will hold your head for 30 seconds or until BPV symptoms stop.
Third, the doctor will hold your head still and you will roll your body so that you are lying on your side, in the same direction your head is facing. At this point, the affected ear that is causing your BPV is still facing upward. Again, you will remain in this position for 30 seconds or until BPV stops.
Finally, you will slowly sit up and hang your legs off the table, in the same direction you were facing when lying down.
The whole session takes about ten to fifteen minutes. If it is successful, the crystals will become dislodged from the semicircular canals and you will no longer experience BPV symptoms.