There are a number of treatments and a number
of manoeuvres to treat benign paroxysmal positional vertigo. However, the Epley manoeuvre is the
most well established and it is the test that has proven to be successful in this condition.
The first part of the Epley manoeuvre is essentially performing the Dix-Hallpike manoeuvre.
Once the head has been extended I always make
sure that if a patient is feeling dizzy or I see some nystagmus, I wait for this to completely
resolve before continuing to perform the next stage of the manoeuvre.
The head is turned 90 degrees towards the opposite shoulder. This means that the head
now lies 45 degrees relative to the vertical plane. You can relax your arms now. What Iíd
like you to do, in your own time, is to roll on to your left hand side and just let me
support your head. Whilst the patient is turning, the head is rotated a further 90 degrees in
the same direction. Finally, the patient is asked to sit up with
her legs over the side of the couch. During this manoeuvre I like to take control of the
head so that I can position it as I would like it to be. At the end of the manoeuvre
I ask the patient to finish so that their chin is sitting nicely on their chest.