The Epley Maneuver for Vertigo

3. Sequence of Positions

Based on a 2003 research study featured in the Canadian Medical Journal Association Journal, the Epley maneuver uses the following sequence of positions:

1. The patient sits upright and fully extends their legs. Rotate the head 45 degrees towards the side that has the loose calcium crystal.
2. While maintaining the rotation of their head, quickly lower the patient so they are lying horizontally with their torso facing up. Hold the neck 30 degrees below horizontal while keeping the head rotated to the side.
3. While the patient holds this position for one to two minutes, observe their eyes for involuntary movements that signify nystagmus.
4. Rotate the patient’s head 90 degrees in the opposite direction while maintaining the 30 degrees of neck extension. Hold this position for one to two minutes.
5. Roll the patient onto their shoulder and rotate their head 90 degrees, so they face downward at a 45-degree angle.
6. Slowly bring the patient into an upright sitting posture while maintaining the rotation of their head.