Epley Maueuver Rocks!

I finally tried the Epley maneuver a few months ago after struggling with vertigo for a few weeks.  As a family physician I was certain that I had benign paroxysmal positional vertigo (BPPV), and that it would likely improve if I just waited it out, but I was getting pretty tired of walking around the office like Frankenstein, head held still, trying not to move suddenly.  For years I had been referring my patients with persistent BPPV to ENT doctors for repositioning therapy, but had not been doing it in the office. Most of the time patients just get better in a week or two without specific treatment.

Finally I used Dr. Google to look up home repositioning therapy after one of my younger partners told me about the Epley maneuvers.   These are really pretty simple, and I did them myself with excellent relief.  Within 2 days I was about 95% free of vertigo symptoms.  Yesterday morning I awoke with a recurrence of the vertigo again.  I use my iPhone as my alarm now, and it was lying on the floor charging at the bedside.  On rolling over to turn off the alarm I got so dizzy with the whole room spinning that I had to quickly lie down and let the alarm keep going.  I finally managed to get the alarm off, but felt pretty lousy.  I got to the office and went right to an exam room, and put myself through the Epley maneuvers, with only slight help.  I struggled through a reduced workload day, and last night again did the maneuvers.

I took care last night to avoid rolling to the left, my affected side, and this morning am much better, at least 90% improved, with no true vertigo.  For those readers who say, “What’s vertigo?” first I’m happy for you that you’ve not experienced this miserable symptom.  It is the type of dizziness where there is a sensation of spinning or movement of yourself or the surroundings. It feels like motion sickness, often associated with nausea and severe imbalance.  It can be caused by inflammation or other disorders of the inner ear, particularly the vestibule (semi-circular canals).  BPPV is a type of vertigo where the fluid and tiny granules in the vestibule get out of position, leading to a sensation of motion and vertigo.

I think I managed to practice for 30 years without knowing about the Epley maneuver because John Epley didn’t describe this treatment until 1980, the year I graduated from Med School, and somehow I never heard about it until recently.  The procedure is really simple, though it can produce really miserable vertigo during the procedure for many patients, and can be tough to do without support from a confident helper, like your physician if your vertigo is severe.  It’s also important not to just assume your vertigo is BPPV as there are other more serious causes that may need diagnosis and treatment.  If there is any doubt of the diagnosis see your physician for evaluation.  Here is a You Tube of the maneuver:

As you can see, it’s not really difficult to do, and I now often suggest to my patients to do it at home, or sometimes do it with them at the office. Now I can just send them to this post for details :.) For more  information on the Epley Maneuver and vertigo and dizziness see a later post on the Epley Maneuver.