Patient information factsheet
Home Epley manoeuvre to treat BPPV
(left ear)
We have written this factsheet to give you more information about benign paroxysmal
positional vertigo (BPPV). It explains what BPPV is, what the Epley manoeuvre
treatment method is and how to perform it safely at home. We hope it will help to
answer some of the questions you may have. If you have any further questions or
concerns, please speak to a member of our team.
What is benign paroxysmal positional vertigo (BPPV)?
BPPV is a common cause of dizziness. It occurs in people of all ages but is more common
in middle-aged and elderly people. It causes short bursts of intense dizziness when the body
or head is placed in certain positions such as lying on one side in bed or looking upwards.
People can feel sick and are sometimes unsteady for a few hours after the dizziness has
gone away.
Benign – this means the cause of dizziness is not a threat to your health.
Paroxysmal – the dizziness comes in short bursts.
Positional – the dizziness is provoked by certain body or head positions.
Vertigo – the medical name for the spinning sensation.
What causes BPPV?
There is a collection of tiny crystals inside your ear. They have a valuable role to play when
they are in the correct position. BPPV occurs when the crystals are dislodged from their
correct position. They move into one or more of the semi-circular canals and either continue
to float around or become attached to another part of the ear.
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Once the crystals are loose, putting your head into certain positions can cause the crystals
to move, making your brain think you are moving even though you are not. If you stay in the
position which makes you dizzy, the crystals will settle and the dizziness will wear off.
The crystals can become dislodged from their normal position for a number of reasons. These
include a head injury or an infection of the inner ear. More commonly it happens for no reason.
BPPV usually occurs in one ear, but some people can have it in both ears at the same time.
How is BPPV treated?
Home Epley manoeuvre
BPPV can usually be cured using the home Epley manoeuvre. This is a simple treatment that
involves you turning your head in a series of movements. The movements are specifically
designed to use gravity to dislodge the crystals from the semi-circular canals and return them
to where they belong, treating the symptoms of vertigo.
You can perform the series of movements in your own home. The movements must be done
on the side in which the symptoms are occurring. In your case, this is your left side.
How do I perform the home Epley manoeuvre?
We recommend that you have a friend or family member present the first few times you
perform this exercise to help you in case you become unsteady. If you would like to watch a
video of the treatment being performed, please visit:
www.youtube.com/watch?v=lh72suV2p20
To perform the exercise, you will need to follow the steps below:
1. Sit up on your bed with your head turned 45 degrees to the left.
2. Lie down on your back as quickly as you can. Your head should be hanging over the edge
of your bed. Make sure you keep your head turned 45 degrees to the left. Wait for around
a minute, or until your dizziness subsides.
3. Turn your head to 45 degrees to the right, keeping your head down and hanging over the
edge of your bed. Wait for around a minute, or until your dizziness subsides.
4. Turn to lie on your right-hand side (making sure you do not lift your head up). Then turn
your head slightly to the right so you are facing the floor. Wait for around a minute, or until
your dizziness subsides.
5. Slowly sit yourself up, tilting your head down to tuck your chin into your chest.
6. Sit for 15 minutes and then repeat steps one to five once more.
1 2 3 4 5
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Are there any risks?
During the treatment, you are likely to experience symptoms of vertigo (dizziness with a
spinning sensation), especially on the problem side. This is quite normal and will pass within a
few seconds. The more you do the series of movements, the less likely you are to experience
these symptoms.
After the treatment, you may feel imbalanced or slightly unwell for up to 48 hours, but this will
pass. If the treatment has been successful, you should no longer experience symptoms of
vertigo.
What should I do after the treatment?
After the treatment, try to avoid tilting your head upwards (head extension), especially
with your head turned towards the affected side, as this may move the crystals back to the
problem area.
One week after the treatment, put yourself in a position that usually makes you feel dizzy to
see if you experience any vertigo symptoms. Make sure that you position yourself safely, so
you can’t fall or hurt yourself.
BPPV can sometimes return after treatment. This can be after a few months or even years.
If it does return and lasts for a couple of weeks, contact us for advice. We may offer you an
appointment to repeat the treatment.
Contact us
If you have any questions or concerns, please contact us.
Audiology and hearing therapy department
Level A
The Royal South Hants Hospital
Brintons Terrace
Southampton
Hampshire
SO14 0YG
Telephone: 023 8120 2997
Email:
[email protected] If you are a patient at one of our hospitals and need this document
translated, or in another format such as easy read, large print, Braille
or audio, please telephone 023 8120 4688.
For help preparing for your visit, arranging an interpreter or accessing
the hospital, please visit www.uhs.nhs.uk/additionalneeds
Version 4. Reviewed February 2024. Due for review February 2027. 2782
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