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Modifications of the Epley manoeuvre for benign paroxysmal positional vertigo (BPPV)

Benign paroxsymal positional vertigo (BPPV) is caused by rapid changes in head position. The person feels they or their surroundings are moving or rotating. Common causes appear to be head trauma or types of ear infection. BPPV can be caused by particles in the semicircular canal of the inner ear that continue to move when the head has stopped moving. This causes a sensation of ongoing movement that conflicts with other sensory information. The Epley manoeuvre has been shown to improve the symptoms of BPPV. This is a procedure that moves the head and body in four different movements and is designed to remove the particles (causing the underlying problem) from the semicircular canals in the inner ear. A range of modifications of the Epley manoeuvre are now used in clinical practice, including applying vibration to the mastoid bone behind the ear during the manoeuvre, having a programme of balance exercises after the manoeuvre has been done, and placing restrictions on a patient's position (for example, not sleeping on the affected ear for a few days). There are also a number of different ways to do the manoeuvre.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

The Epley manoeuvre for benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is caused by a rapid change in head movement. The person feels they or their surroundings are moving or rotating. Common causes are head trauma or ear infection. BPPV can be caused by debris in the semicircular canal of the ear, which continues to move after the head has stopped moving. This causes a sensation of ongoing movement that conflicts with other sensory information. The Epley manoeuvre is a treatment that is performed by a doctor (or other health personnel with appropriate training, e.g. audiological scientist, physiotherapist) and involves a series of four movements of the head and body from sitting to lying, rolling over and back to sitting. It is understood to work by moving the canal debris out of the semicircular canal. This linked video demonstrates how the Epley manoeuvre is performed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Positional vertigo: Can the Epley maneuver help against sudden attacks of dizziness?

The Epley maneuver is a simple treatment for the relief of a type of vertigo known as “benign paroxysmal positional vertigo” (BPPV). It is considered as a treatment option if the vertigo is being caused by deposits in the ear’s organ of balance.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 30, 2014

Positional vertigo: Overview

Getting up and feeling like everything around you has suddenly started spinning is anything but pleasant. About 2% of the population are affected by “benign paroxysmal positional vertigo” (BPPV) at some point in their lives. Research has shown that an approach known as the Epley maneuver can help the dizziness go away again in a lot of people.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 30, 2014

Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis)

Idiopathic acute vestibular dysfunction (vestibular neuritis) is a common condition of unknown cause. Patients with the condition often experience dizziness, nausea or vomiting, and trouble with vision, balance or mobility, but have normal hearing and no tinnitus. It has been proposed that a course of corticosteroids, if given early on, may improve recovery from the condition and long‐term patient outcome. However, corticosteroids can cause adverse effects (e.g. bleeding stomach ulcer, mood changes, etc.).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Vestibular rehabilitation to improve dizziness, balance and mobility in patients with unilateral peripheral vestibular dysfunction

People with vestibular problems often experience dizziness and trouble with vision, balance or mobility. The vestibular disorders that are called unilateral and peripheral (UPVD) are those that affect one side of the vestibular system (unilateral) and only the portion of the system that is outside of the brain (peripheral ‐ part of the inner ear). Examples of these disorders include benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis, one‐sided Ménière's disease or vestibular problems following surgical procedures such as labyrinthectomy or removal of an acoustic neuroma. Vestibular rehabilitation for these disorders is becoming increasingly used and involves various movement‐based regimes. Components of vestibular rehabilitation may involve learning to bring on the symptoms to 'desensitise' the vestibular system, learning to co‐ordinate eye and head movements, improving balance and walking skills, and learning about the condition and how to cope or become more active.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

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