Edward Cho of House Clinic demonstrates the Epley Maneuver for benign paroxysmal positional vertigo.
![epley maneuver video for vertigo epley maneuver video for vertigo](https://1.bp.blogspot.com/-9lq9toDtKT4/XXCQJ8b4XlI/AAAAAAAAAR8/TqVp6OG4PHw-fLlurYs515lVJV1ELnhBwCLcBGAs/s1600/Epley%2Bmaneuver%2Bfor%2Bvertigo.gif)
These maneuvers are necessary to successfully treat these canals. If your position changes of the head are too slow then the crystal settles back where it was.Ī lack of liberating maneuvers for an anterior canal or horizontal canal problem will fail to clear a crystal. Head position is CRITICAL in treating positional vertigo. If above does not work to relieve nausea and dizziness, try: Lie down on your back, turn. Sit up slowly, head tilted forward for 1 minute. Turn whole body to right, head facing towards floor for 1 minute. Lie down on your back, turn head to left for 1 minute. If you do not properly position the canal in a dependent position with gravity and allow the crystal to fall and settle your treatment “will fail”. Epley Maneuver for Benign Positional Vertigo. Christopher Chang, ENT comments on treatment of positional vertigo. These treatments do not follow the physics of moving a small crystal in a curved, fluid filled tube. Treatments that will NOT treat positional vertigo are a Brandt-Daroff exercise as well as Gyrostim. It will also return and can cause other symptoms in the meantime. You or your patient will feel better but not fully, and now this problem is more difficult to find and to treat. If you are unsure of the canal or side (remember there are 3 on each side) you can shift the crystal further down the semicircular canal, getting it stuck. This can be helpful but does not ‘fix’ the problem. A lot of cases of vertigo get better week by week without treatment as our vestibular nuclei shift their input to ignore this problem creating a unilateral vestibular hypo-function. The cool thing is this! As we continue to stimulate the cupula we see a blunting of the cupular response. It is this abnormal information that causes vertigo. What happens next is the cause of vertigo.Ī crystal starts to sink stimulating the cupula or sensing organ of it’s canal to fire while the other 5 canals are telling the brain that there is no movement of the head. The sensing organ, the cupula, stops its deflection telling the brain that there is no longer any acceleration changes to the head. When our head stops moving the endolymph or fluid in our semicircular canals settles.
![epley maneuver video for vertigo epley maneuver video for vertigo](https://www.pristyncare.com/blog/wp-content/uploads/2019/11/epley-manuever-for-BPPV-e1573650634237.jpg)
If they end up in the semicircular canals then vertigo can occur. If they stay in the vestibule then there are no symptoms. Over time pieces of the otolith can break off. Head injury or whiplash can create fractures in the Otolith crystals.