Harvard Health Letter

The Epley Maneuver

Benign Positional Vertigo (BPV) — the name is a mouthful, but it conveys a lot of information. A mild, if very annoying condition, BPV is truly benign. The symptoms are brief and intermittent, and they are invariably triggered by a change in head position. And the main symptom is true vertigo.

BPV is the most common form of vertigo. It can strike people of all ages, but it typically targets those over 50. In BPV, dizziness is triggered by head motions such as turning over in bed, getting in or out of bed, bending over or straightening up, or craning the neck to look up. The vertigo may be severe, but it is short-lived, usually resolving in 15 seconds or less.

Doctors can suspect BPV on the basis of its characteristic symptoms, and they can confirm the diagnosis with a simple test, the Hallpike-Dix maneuver. You'll be asked to sit on an exam table with your head turned 45 degrees to the side. Then you'll be tilted back so your head is hanging off the table. Your doctor will hold your head to one side for 30–60 seconds, then repeat the process with your head turned 45 degrees to the other side. If you feel dizzy during the test and your doctor detects a characteristic movement of your eyes called nystagmus, the diagnosis of BPV is established, and you won't need additional tests.

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