The Epley Maneuver - A Simple Treatment for One Type of Vertigo

From Our Mailbag:

I woke up with vertigo. I read it's ear-related and I did have some pain in one ear after my run a few nights ago...but otherwise no issues. Thoughts?

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Hopefully, it was just dizziness that you experienced from over-exertion and dehydration.

True vertigo where one feels her surroundings are spinning and there is a significant loss of balance can be caused by a few different issues, one of them being a loose calcium deposit or two within the semicircular canals in the inner ear - this is called benign paroxysmal positional vertigo, and is characterized by the following:

• Short duration of sudden-onset episodes of unexplained dizziness
• Nausea
• Vomiting when vertigo is severe
• A disturbance in vision, typically related to nystagmus (involuntary eye movement in a back-and-forth manner)

There is a method called the Epley maneuver that involves having someone assist you in moving your head and upper body in a way that guides any loose crystals out of your semicircular canals. Here is a simple video that demonstrates the Epley maneuver:

The idea is to start on a stable surface with your head turned about 45 degrees toward the affected side. The person helping you should tilt your upper body back quickly to have you lie on your back where your head is hanging off the side of the surface you are sitting on with your head still turned about 45 degrees. You want to maintain this position for about 20 seconds, then turn your head to face the other way, again, about 45 degrees, hold for 20 seconds, then rotate your body so that your trunk is facing the direction that you just turned your head toward, hold for another 20 seconds (you should almost be looking at the floor at this point), then bring yourself up to a seated position.

Here is another video that provides a look at what one is trying to accomplish within the inner ear with the Epley maneuver:

A lot has to go right for this to be successful, so if you think you have this type of vertigo, you may try it more than once if your first attempt doesn't lead to significant improvement.

Hopefully, it was just dizziness that you experienced - fingers crossed that this was the case! Also - sometimes, vertigo can be caused by inflammation in the inner ear - this type of vertigo will disappear as inflammation subsides. You mentioned pain in your ear, so this might be what you experienced.

Addendum:

Hello Dr Kim,

I have had recurring bouts of BPPV over the years and have learned to do the Epley maneuver on myself. Something I think is very important, which the video doesn't explain, is how to tell which is the affected side. I'm sure you know that doing the maneuver for the wrong side can make symptoms worse instead of better.

A simple way I've found to find the affected side is, when standing facing forward, look up letting your head fall back and then turn your head to look over your right shoulder for about 3 seconds. If you experience dizziness, then your right side is your affected side. The same goes for the left side.

Thank you

Barb T.

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Also added to the top of this post is the "Half Somersault Maneuver to Treat BPPV Vertigo," a method that one can try on his or her own.