How effective is the Epley manoeuvre for BPPV?

Benign paroxysmal positional vertigo happens when tiny calcium particles move into a sensitive inner-ear canal. Turning the head and body through a planned sequence can guide those particles toward an area where they are less likely to trigger false movement signals.

The manoeuvre is designed for a particular pattern of positional vertigo. A clinician may first use positional testing to identify the affected side and canal. If the diagnosis is different, or if the manoeuvre is performed for the wrong side, it may not help and can make dizziness temporarily more noticeable.

Have the first manoeuvre assessed or taught by a qualified clinician, especially if you have neck or back problems, limited movement, vascular disease or retinal problems. Move slowly, use a secure surface and have someone nearby if dizziness affects your balance.

Brief spinning or nausea can occur during position changes. Follow the aftercare instructions you were given and avoid driving or climbing until you can turn and walk safely. If symptoms remain, return for reassessment rather than repeating a guessed version at home.

Seek emergency help for dizziness with new weakness, facial drooping, trouble speaking, double vision, severe headache, fainting, chest pain or inability to walk. These features are not typical of simple positional vertigo.

Arrange medical review if hearing loss, severe continuous vertigo, fever, repeated vomiting or a new severe headache accompanies the dizziness. Persistent symptoms after a manoeuvre may mean another cause needs consideration.

Which ear and canal are affected? Is a home manoeuvre appropriate for me, and how should I protect my neck? How will we know whether remaining dizziness is BPPV or needs another assessment?