The Epley Maneuvers, also known as the Canalith Repositioning Procedure (CRP), are designed to treat benign paroxysmal positional vertigo (BPPV) through induced out-migration of free-moving pathological densities in the endolymph of a semicircular canal, using timed head maneuvers and applied vibration. In simpler terms, canaliths (calcium carbonate crystals) are normally attached atop a membrane in the otolith organ (or gravity center) of the inner ear. These crystals can break off for various reasons, most commonly, injury or disease, and migrate into a semicircular canal. Then, when the head position is changed, the canaliths shift, abnormally stimulating the nerve sensor (cupula) of the affected semicircular canal and creating a sensation of movement (vertigo). In treatment, the head is maneuvered so as to guide the canaliths (also referred to as otoliths or cupuloliths, depending on their placement) back though the labyrinth to where they originated. To facilitate this process, the canaliths can be tracked by observing the eye movements they cause, and by applying an oscillator to the skull. In most medical facilities, this maneuvering is done by hand with the patient lying on a table. The Portland Otologic Clinic uses special automated equipment (the OMNIAX Positioning System), which positions the patient and allows observation of eye movement via miniature video cameras. This provides an advantage in diagnosing and treating difficult or complicated cases, including variations of BPPV.

A former method was to surgically destroy the function of the balance system in the involved ear, allowing the opposite side to take over. Then Dr. Epley demonstrated that the problem could also be cured by repositioning the canaliths. Validated internationally by numerous institutional studies, this treatment is now known around the world as "The Epley Maneuvers". It provides a low risk, non-invasive and highly effective alternative.

If you can't find a local physician who knows how to carry out this treatment, consider giving your primary physician or local otolaryngologist the information for ordering the professional videotape course regarding "The Epley Maneuvers". This course covers diagnosis and treatment in detail.

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