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The Epley maneuver or repositioning maneuver is a maneuver used by medical professionals to treat one common cause of vertigo, benign paroxysmal positional vertigo (BPPV) [1] [needs update] of the posterior or anterior canals of the ear. [2]
When performing the Dix–Hallpike test, patients are lowered quickly to a supine position (lying horizontally with the face and torso facing up) with the neck extended 30 degrees below horizontal by the clinician performing the maneuver. [3] The Dix–Hallpike and the side-lying testing position have yielded similar results.
The device is filled with fluid and a particle representing the otoconia (loose hard particles) associated with BPPV. The device works like a visual set of instructions and guides the user through the treatment maneuver for BPPV. This maneuver is called the particle repositioning maneuver or Epley maneuver.
Positive Dix–Hallpike test after other possible causes have been ruled out [1] Differential diagnosis: Labyrinthitis, Ménière's disease, stroke, vestibular migraine [3] [4] Treatment: Epley maneuver or Brandt–Daroff exercises [3] [5] Prognosis: Resolves in days to months [6] Frequency: 2.4% affected at some point [1]
Cawthorne-Cooksey exercises are exercises described in the 1940s to treat soldiers who had suffered injuries that resulted in balance problems during the war. [1] It forms the basis of the Epley maneuver which is the modern treatment of benign paroxysmal positional vertigo .
Inspection; Palpation of sternoclavicular joint, clavicle, acromioclavicular joint, subacromial bursa, bicipital tendon.; Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain.
The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition. [1] In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes. [9]
Dix–Hallpike test: Margaret R. Dix, Charles Skinner Hallpike: otolaryngology: Benign paroxysmal positional vertigo: synd/3615 at Who Named It? Elicitation of extreme vertigo upon lateral movement of a patient's head when lying in a supine position Döhle bodies: Karl Gottfried Paul Döhle: pathology: various including trauma and neoplasm