Epley and Semont Maneuvers for Vertigo
Treatment Overview
The Epley and Semont maneuvers are
exercises used to treat
benign paroxysmal positional vertigo (BPPV). They are
done with the assistance of a doctor or physical therapist. A single 10- to
15-minute session usually is all that is needed.
When your head
is firmly moved into different positions, the
calcium crystal (canalith) debris causing vertigo will slip out of the
semicircular canal into an area of the inner ear where it will no longer cause
symptoms. Two maneuvers have been used successfully: the Epley maneuver and
the Semont maneuver.
The Epley maneuver is performed as follows:
- You are seated, and the doctor turns your head 45 degrees
horizontally toward the affected ear. You should hold the doctor's arms for
support.
- The doctor tilts you backward to a horizontal position with your
head kept in place at a 45-degree turn, hanging. An attack of vertigo is likely
as the debris moves toward the apex of the canal. You are held in this position
until the vertigo stops, usually within a minute.
- The doctor turns your head 90 degrees toward the unaffected ear.
The doctor then rolls you onto the side of the unaffected ear, so that you are
now looking at the floor. The debris should move in the canal again, possibly
provoking another attack of vertigo. You should remain in this position until
the vertigo stops, usually within a minute.
- The doctor helps you back to a seated position.
The
Semont maneuver is performed as follows:
- You are seated, and the doctor turns your head so that it is halfway
between looking straight ahead and looking away from the side that causes the
worst vertigo.
- The doctor then lowers you quickly to the side that
causes the worst vertigo. When your head is on the table, you are looking up at
the ceiling. The doctor holds you in this position for 30
seconds.
- The doctor then quickly moves you to the other side of the
table without stopping in the upright position. When your head is on the
table, you are now looking down at the table. The doctor holds you in this
position for 30 seconds.
- The doctor then helps you sit back
up.
In some cases, your
doctor or physical therapist may have you do a modified Epley procedure at
home. If your doctor has shown you how and you feel confident, you can try this
at home to get rid of your vertigo.
What To Expect After Treatment
The Epley and Semont
maneuvers may improve or cure benign paroxysmal positional vertigo (BPPV) with only
one treatment. Some people need multiple treatments.
Why It Is Done
Epley and Semont maneuvers
are used to treat BPPV.
How Well It Works
The Epley procedure is
safe and works well to treat benign paroxysmal positional vertigo
(BPPV).1
The Semont maneuver may work to
stop symptoms of BPPV. But the evidence is not as good as it is for the
Epley procedure.1
Risks
These maneuvers should not be done on people with back or spine injuries or problems.
Sometimes the maneuver can move the debris from one inner ear canal to another. This can cause a different kind of vertigo.
What To Think About
The Epley and Semont
maneuvers are more effective than other treatments for BPPV, such as exercises
(for example, the Brandt-Daroff exercise).1 Exercises
do not treat the cause of BPPV. They help speed up
compensation by the brain. When the Epley and Semont maneuvers work, they can relieve symptoms of vertigo
quickly.
If the Epley and Semont maneuvers don't work to relieve your symptoms of vertigo, you may not have the most common type of BPPV. Or you may not have BPPV at all.
Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.
References
Citations
- Fife TD, et al. (2008). Practice parameter: Therapies
for benign paroxysmal positional vertigo (an evidence-based review). Report of
the Quality Standards Subcommittee of the American Academy of Neurology.
Neurology, 70(22): 2067–2074.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Last Revised | December 19, 2012 |
|---|
Last Revised:
December 19, 2012
Fife TD, et al. (2008). Practice parameter: Therapies
for benign paroxysmal positional vertigo (an evidence-based review). Report of
the Quality Standards Subcommittee of the American Academy of Neurology.
Neurology, 70(22): 2067–2074.
