The Epley maneuver or repositioning maneuver is a maneuver used to treat benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals.
Epley maneuver: Step 1
You will sit on the doctor's exam table with your legs extended in front of you. The doctor will turn your head so that it is halfway between looking straight ahead and looking directly to the side that causes the worst vertigo. Without changing your head position, the doctor will guide you back quickly so that your shoulders are on the table but your head is hanging over the edge of the table. In this position, the side of your head that is causing the worst vertigo is facing the floor. The doctor will hold you in this position for 30 seconds or until your vertigo stops.
Epley maneuver: Step 2
Then, without lifting up your head, the doctor will turn your head to look at the same angle to the opposite side, so that the other side of your head is now facing the floor. The doctor will hold you in this position for 30 seconds or until your vertigo stops.
Epley maneuver: Step 3
The doctor will help you roll in the same direction you are facing so that you are now lying on your side. (For example, if you are looking to your right, you will roll onto your right side.) The side that causes the worst vertigo should be facing up. The doctor will hold you in this position for another 30 seconds or until your vertigo stops.
Epley maneuver: Step 4
The doctor will then help you to sit back up with your legs hanging off the table on the same side that you were facing.
A single 10- to 15-minute session usually is all that is needed. When your head is firmly moved into different positions, the crystal debris (canaliths) causing vertigo will move freely and no longer cause symptoms.