Epley 2

So you’ve woken up, rolled over in bed and suddenly felt the entire room spinning uncontrollably around you.  You visit your doctor, or nervously google online to come up with a diagnosis of BPPV (Benign Paroxysmal Positional Vertigo).  Further searching on the internet uncovers a possible solution…..the Epley Manouevre.

If you’re feeling hesitant about trying it, you’re not alone, and you’re not completely wrong.

The Epley is certainly an effect treatment for specific types of BPPV and we administer it daily in our clinic.  What you may not know is that the Epley can only treat 4 types of BPPV.  Our inner ear however, is capable of being afflicted with 12 different types!  So there is some risk that this manoeuvre will not be applied to the correct vestibular problem.  Along with this, is the probability that the manoeuvre, though the correct one, won’t be performed properly.

Does this really matter?

In many cases, no.  However we see approximately 10 BPPV cases per year where this has complicated the problem.  A well-done, appropriately applied Epley can move dislodged calcium carbonate crystals back in place.  In improper one can sometimes move these crystals into a different canal, or worse, can adhere them to a structure called the cupula in the deeper part of the inner ear canals.  This “cupulolithiasis” type of BPPV can be more much difficult to treat.

My advice?  I recommend the home or self-Epley treatment option for patients who meet the following criteria:

  • You’ve had BPPV before, and it’s been properly diagnosed (I find it often isn’t).
  • Your prior episodes have been completely resolved with the Epley (usually only takes 1-3 attempts).
  • The symptom patterns of your current episode are very similar to your prior episodes.
  • You are confident that you (or your helper) can perform the Epley correctly.

Cornerstone Physiotherapy has several vestibular therapists that can expertly diagnose your type of BPPV, and treat it with the Epley, Gufoni’s, Semont’s or any other appropriate manoeuvre.  Dizzy?  We can help!