Normally only with head movement does fluid within the inner ear also move informing the brain that a head turn occurred however should a crystal called an otolith that gets displace into the poster canal of the inner ear, BPPV dizziness occurs. Fluid movement occurs due to the crystal rather than head turns causing the brain to think movement has occurred even though none has happened. When the Epley maneuver is performed to treat this posterior canal BPPV by trying to get the loose crystal out of the canal this maneuver is started by turning the head fortyfive degrees and the body.
Laid back such the head is extended about 20 to 30 degrees. If BPPV is present, eye twitching call nystagmus will occur. After 30 to 60 seconds the head is turned 90 degrees to the opposite side and held for another 30 to 60 seconds The head is then further rotated another 90 degrees accomplished by having the patient turn onto their side which is then held for another 30 to 60 seconds. At this point the head should be turned 45 degrees from the horizontal. When performing this maneuver another individual can help with these position.
Changes the maneuvers then completed by having the patient sit up. So what’s going on with these position changes Essentially the head has moved in such a way to manipulate the crystal to fall towards the canal opening. With each position change it takes about 30 to 60 seconds for the crystal to settle into the most dependent position in the canal. If turns are made before the crystal has a chance to settle the crystal may fall back the wrong way and the maneuver will fail. It is also important that they head positions are angled correctly.