Epley's manoeuvre

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  • Epley's manoeuvre (canalith repositioning procedure) (1)
    • been devised to remove debris from the semicircular canals and deposit it in the utricle where hair cells are not stimulated
    • vestibular sedatives, given one hour before Epley's manoeuvre, may be useful in severe cases.
    • Epley's manoeuvres consists of:
      • the Hallpike manoeuvre:
        • the patient is seated upright
        • the head is turned towards the affected side (say the left)
        • with the head still turned, the patient is reclined past the horizontal
        • hold for 30 seconds
      • in the reclined position the head is turned to the right
        • hold for 30 seconds
      • the patient is rolled onto their right side
        • the head is still turned to the right (the patients is now looking towards the floor)
        • hold for 30 seconds
      • the patient is sat upright, still look over their right shoulder
        • hold for 30 seconds
      • the patient turns the head to the midline with the neck flexed, chin down through 45 degrees
        • hold for 30 seconds

    • contraindications to canalith repositioning procedures include (1):
      • severe carotid stenosis
      • unstable heart disease
      • severe neck disease (cervical spondylosis with myelopathy)
      • advanced rheumatoid arthritis
    • Click here for video of Epley's manoeuvre

  • Semont manoeuver (also called the liberatory maneuver) (2)
    • involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other.(2)
    • more difficult to perform and more uncomfortable for the patient than the Epley maneuver (3)
    • Click here for video of Semont manoeuvre


Last reviewed 01/2018