positional manoeuvres in benign positional vertigo
Last reviewed 11/2023
- 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
- hold for 30 seconds
- the Hallpike manoeuvre:
- 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
Reference: