What if the Epley manoeuvre does not relieve dizziness?

The Epley manoeuvre is intended for a particular inner-ear pattern in which movement can shift small particles. Dizziness may continue if the diagnosis is different, the manoeuvre was performed for the wrong side, the particles have moved into another canal, or a separate balance, migraine, vision or neurological problem is involved. Mild disequilibrium can also remain after spinning episodes settle.

Describe what you feel: brief spinning when turning in bed differs from light-headedness, unsteadiness or faintness. Tell the clinician which movement triggers it, how long each episode lasts, and whether hearing symptoms, headache, weakness or numbness occur.

Arrange a review with a GP, vestibular clinician or ear specialist if the manoeuvre has not helped, especially before repeating it many times. Move slowly, sit down when symptoms start and use support on stairs. Avoid driving, heights or machinery while attacks make your balance unreliable.

Keep a symptom record and bring details of which side was treated and how the manoeuvre was performed. A clinician may reassess your eye movements and balance and decide whether another treatment or a different evaluation is needed.

Seek emergency care for dizziness with facial drooping, arm or leg weakness, trouble speaking, severe new headache, fainting, chest pain, inability to walk or sudden vision loss. Get prompt medical advice for new hearing loss, severe vomiting, fever, head injury or symptoms that are continuous and worsening.

Does my pattern fit positional vertigo, and was the correct side treated? Could migraine, an inner-ear disorder or another problem explain the dizziness? Should I have balance or hearing tests? Which movements and activities are safe while symptoms continue?