Epley maneuver

Description

There are several sequentially executed 90 ° rotations of the head about different axes, each in an arcade level: First, the patient sits on the examination table and rotates the head 45 ° to the affected side. Then he lies down rapidly to 90 ° back and lowers his head in addition to 30 ° over the back edge of the couch. The affected ear is below. The examiner can now watch a nystagmus. After the patient is positioned about one minute, he then rotates the head 90 ° to the opposite side and is one minute in this position again. Then rotates the body and head together again by 90 ° on the side of the head. The last two rotations cause a nystagmus to the affected, lying above the ear, if the maneuver was successful. Now the patient lies on the unaffected side with the normal ear facing the ground. Again, after a minute of waiting, the patient is directed to complete and sits at the end of the maneuver at the lateral edge of the couch.

In about half of the patients already runs an application to symptoms. The maneuver can be repeated any number of times. Important for the success of the treatment is the speed of execution of the movements of the head in space. All other movements can be performed slowly. Contrary to the original description of Epley introduces an additional vibration on the mastoid does not improve the success of treatment.