How the Epley Maneuver Can Help Relieve BPPV Symptoms Fast

Have you ever woken up feeling like the room is spinning, even though you’re lying perfectly still? Or perhaps you’ve noticed sudden dizziness when rolling over in bed, getting up, or simply tilting your head to look up? These brief, unsettling sensations may be signs of a common inner ear condition called Benign Paroxysmal Positional Vertigo (BPPV)—a condition that’s often easily treatable.

BPPV is one of the most frequent causes of dizziness, especially in adults over the age of 65. While the symptoms can feel alarming, BPPV is usually harmless and can often be relieved through simple, guided head movements— known as Repositioning Maneuvers, such as the Epley maneuver, Zuma maneuver etc which we’ll explore in this blog.

How Your Inner Ear Works (and Why It Matters for BPPV)

Your inner ear helps to keep you balanced. In the inner ear, there is a part called the vestibular system which includes tiny tubes filled with fluid referred to as semicircular canals. They are set at various angles to check for the movement of the head.

As your head moves, the fluid within the canals shifts as well. It tells your brain about how fast and in which direction you are moving. As a result, your brain understands your body’s movements and helps you not fall over.

There is also a part of the inner ear called the utricle and it holds very small calcium crystals. Crystals in your body assist you by helping you sense where you are moving in a straight line.

What Happens in BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. It happens when some of the crystals from the utricle become loose and move into one of the semicircular canals.

When this occurs:

• The loose crystals move when your head moves.
• They push the fluid in the wrong way inside the canal.
• This sends confusing signals to your brain.
• As a result, you feel dizzy or as if the room is spinning, even if your body isn’t actually moving much.

Imagine a tube filled with water containing tiny rocks moving around inside. Their unpredictable movement makes it challenging to track or understand

What Can Trigger BPPV?

Sometimes doctors don’t know why BPPV happens. That’s called idiopathic BPPV. However, there are some known causes and risk factors:

• Head injury, even a mild one
• Aging, especially in people over 65
• Inner ear infections or inflammation
• Migraine headaches
• Staying in one position for too long, such as during bed rest or a long dental appointment
• Ear surgery or, in rare cases, a stroke
• Family history of BPPV
• Other health conditions like high blood pressure, high cholesterol, or giant cell arteritis

Understanding these triggers can sometimes help people be more aware of situations that might lead to an episode. However, BPPV often occurs without any clear reason.

Diagnosing BPPV with VNG-Guided Positional Tests

If you experience dizziness and suspect it could be Benign Paroxysmal Positional Vertigo (BPPV), your doctor will begin by discussing your symptoms—especially when and how they occur. To confirm the diagnosis, a series of Videonystagmography (VNG)-guided positional tests are performed. These tests help detect abnormal eye movements (nystagmus), which signal the presence and location of displaced calcium crystals in the inner ear.

Common VNG-guided tests used to diagnose BPPV include:

• Dix-Hallpike Test: Used to identify BPPV in the posterior semicircular canal, this test involves moving your head and body into specific positions while monitoring your eye movements and asking if you feel dizzy.
• Supine Roll Test: This evaluates BPPV in the horizontal semicircular canal by gently rolling your head from side to side while you’re lying down, checking for characteristic nystagmus and dizziness.
• Deep Head Hanging Test: Primarily used for the anterior semicircular canal, this test is also performed under VNG guidance and may be part of both diagnosis and treatment, helping reposition the dislodged crystals.

Since BPPV can sometimes occur alongside other vestibular disorders—such as vestibular migraine, vestibular neuritis, or Meniere’s disease—a complete vestibular evaluation is essential. This ensures other causes are ruled out and the most accurate treatment approach is taken.

Once confirmed, BPPV is typically very manageable, often with simple, targeted maneuvers that can significantly reduce or eliminate symptoms.

Treatment Options and Maneuvers for BPPV

BPPV is a mechanical disorder of the inner ear caused by the displacement of tiny calcium carbonate crystals from their normal position in the utricle into one of the semicircular canals. This displacement causes the spinning sensation and dizziness typical of BPPV.

Treatment focuses on repositioning these crystals back to their original place. This is done through specific head and body movements called repositioning maneuvers. Several effective maneuvers are used depending on the type and location of BPPV:

• Epley Maneuver: The most common and effective treatment for posterior canal BPPV, involving a series of head and body movements that guide crystals back to the utricle. It has an 80–90% success rate and is safe, non-invasive, and often can be performed at home after initial guidance.
• Semont Maneuver: A rapid side-lying movement used as an alternative for posterior canal BPPV, especially when the Epley maneuver is not suitable.
• Barbeque Maneuver: Used primarily for horizontal canal BPPV, involving a series of head rotations while lying down to move crystals out of the canal.
• Zuma Maneuver: A less common technique designed for horizontal canal BPPV, involving sequential head and body positions.
• Gufoni Maneuver: Also used to treat horizontal canal BPPV, particularly effective in cases of geotropic or apogeotropic nystagmus.

These maneuvers are often performed under the guidance of a healthcare professional and may be combined with vestibular rehabilitation exercises. Most patients experience significant relief after one or two sessions. Studies show the Epley maneuver works for about 80–90% of people. Sometimes it might need to be done more than once, but it almost always helps. Best of all, it’s safe, doesn’t need any medicine or surgery, and you can even learn how to do a version of it at home if your dizziness comes back later.

The Epley maneuver is a quick and effective way to get your balance back and stop the spinning feeling caused by BPPV.

Can You Do the Epley Maneuver at Home?

Yes, there’s a version of the Epley maneuver that some people are taught to do at home, especially if their BPPV (a type of dizziness caused by loose crystals in the inner ear) keeps coming back. However, you should get an accurate diagnosis and observe a trained person using it before using it yourself.

At NeuroEquilibrium clinics, our doctors and vestibular therapists are specially trained to diagnose BPPV and guide you through the maneuver safely and effectively. While it may seem simple, doing it incorrectly can make symptoms worse or cause confusion if the wrong ear is treated.

That’s why we strongly recommend coming in for a proper evaluation before attempting anything at home. Our team will:

• Confirm whether BPPV is the real cause of your dizziness
• Identify which ear and canal are affected
• Perform the Epley maneuver correctly based on your condition
• Teach you a safe, tailored version (if needed) for home use

Even though step-by-step instructions for the home Epley maneuver are widely available, not everyone should try it on their own, especially if you have neck or back issues, eye problems like retinal detachment, or vascular conditions.

If you feel dizzy or suspect you have BPPV, the best way to recover quickly and safely is to contact NeuroEquilibrium. We rely on the latest equipment and our extensive experience to assist you with balance and dizziness issues.

What Happens After the Epley Maneuver?

Most people feel a big improvement in their dizziness soon after doing the Epley maneuver, especially when it’s done correctly by a trained professional. At NeuroEquilibrium, we see many patients walk out of their appointment feeling more stable and less dizzy almost immediately.

Your doctor may offer you some simple approaches to ensure the crystals in your ear settle well. Such examples may consist of:

• Avoiding quick or jerky head movements
• Sleeping with your head slightly raised for a night or two
• Not sleeping on the side that triggered your symptoms
• Avoiding bending down or looking up too much for the first day
• Waiting about 10 minutes before standing up after the procedure

These are just general suggestions. Your NeuroEquilibrium specialist will give you clear, personalized instructions depending on your condition.

It’s also important to know that BPPV can sometimes come back. If your symptoms return, the good news is that the Epley maneuver can usually be done again, with great results.

Conclusion

Benign Paroxysmal Positional Vertigo (BPPV) can be unsettling, but the good news is it’s often very treatable. Gaining knowledge about your inner ear and how to treat it with the Epley maneuver can be very beneficial for you.

Should you feel dizzy, particularly when you change your body position or look around, don’t ignore the feeling. If you get a proper diagnosis and the suitable treatment, you can find relief quickly and for a long time.

We are experts at recognizing and managing balance issues such as BPPV at NeuroEquilibrium. We can instruct you in the Epley maneuver so that you can recover your balance and enjoy your daily life.Don’t let vertigo disrupt your routine, get the support you need with NeuroEquilibrium. Book an appointment today.

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