At Home Epley
In these novel times of “patient self treatment”, I have seen a stark and dramatic upswing of patients doing “At Home Epley maneuvers”. From your online “google” research you have learned that the Epley maneuver is an exercise of sorts that involves manipulating and maintaining the head in certain positions to move the calcium deposits out of the semicircular canals and back into the parts of the ear to which they belong. The Epley maneuver is indicated for clients who have been diagnosed with benign paroxysmal positional vertigo (BPPV). Not everyone who is dizzy has BPPV.
Is The Epley maneuver for everyone? Unfortunately it is not a vestibular cure-all.
Questions you should ask yourself:
- “How long do your symptoms last?” If longer than a few seconds, this is generally not a condition that can be helped with The Epley. Likewise, if you have had these symptoms for years, this is not BPPV.
- “Do you have any other symptoms in your ears?” Ringing, buzzing, pain, aural fullness, discharge, changes in hearing, and of course dizziness or vertigo are all conditions which would warrant a referral to an audiologist (not a hearing aid clinic, there is a difference).
- Which ear is affected? Performing the Epley is quite specific. Head at 30° is just that. Very few people know when their head is at 30° of their own avail. Doing the Epley incorrectly makes it far more likely to be not only unsuccessful, but detrimental. Similarly, which canal is affected? Is this a canal that The Epley could serve? Do you need the Semont? The Brandt-Daroff? The BBQ roll? The GRM?
- Is there a confirmed positive Dix Hallpike with nystagmus? Is the nystagmus upbeating or sidebeating? Is it rotational in nature?
- Has a carotid artery screening been performed? This can be extremely unnerving and dangerous to uncover while performing the Epley Maneuver on yourself.
- Have you googled “drop attack”? Tumarkin’s otolithic crisis can occur post-Epley and is quite terrifying.
It is important to know that it is not safe to use YouTube as a resource.There are currently over 3,300 videos available on YouTube related to performing the Epley maneuver. Out of these videos, only 21 were rated as accurate by a group of neuro-otologists.* Credible YouTube videos were produced from organizations like the American Academy of Neurology.
The point this post: DO NOT DO THE EPLEY ON YOURSELF.
Kevin A. Kerber, James F. Burke, Lesli E. Skolarus, Brian C. Callaghan, Terry D. Fife, Robert W. Baloh, A. Mark Fendrick, Neurology Jul 2012, 79 (4) 376-380; DOI: 10.1212/WNL.0b013e3182604533