When is the Epley manoeuvre recommended for benign positional vertigo?

BPPV causes short bursts of spinning when the head changes position, such as turning in bed, looking up, or sitting up. It happens when tiny calcium particles move into a sensitive part of the inner ear. The manoeuvre uses a sequence of head and body positions to guide those particles away from that area. It is aimed at typical positional vertigo, not unexplained dizziness, fainting, new hearing loss, or vertigo with neurological symptoms.

Arrange an assessment if the pattern is new, persistent, or difficult to describe. A clinician may ask which movement triggers the spinning and perform positional testing before choosing the manoeuvre. Follow the demonstrated sequence carefully; the correct direction depends on the affected ear. Move slowly, have someone nearby if you feel unsteady, and avoid driving until the spinning has settled. Do not force the positions if neck or back movement is unsafe for you.

Seek urgent medical help for vertigo with weakness, facial drooping, trouble speaking, severe new headache, fainting, chest pain, inability to walk, or new double vision. Arrange prompt clinical review if dizziness is continuous rather than position-triggered, follows a significant head injury, or comes with new hearing loss, severe vomiting, or a high fever.

Ask whether your symptoms fit BPPV, which ear is affected, whether the manoeuvre is suitable with your neck or back history, and what you should do if spinning returns after treatment.