Treatment for BPPV, anterior canal, right side, reverse Epley maneuver

By Marcello Cherchi, MD PhD

The reverse Epley maneuver treats anterior canal benign paroxysmal positional vertigo (BPPV) (Bhandari et al. 2021; Korres et al. 2010).  Crevits (Crevits 2004) credits Honrubia and colleagues (Honrubia et al. 1999) with having first described the reverse Epley maneuver.  The reverse Epley maneuver It is less commonly used than other maneuvers for anterior canal BPPV. 

The Figure below, from Korres and colleagues (Korres et al. 2010), illustrates the reverse Epley maneuver for right anterior canal BPPV. This is identical to the regular (not reversed) Epley maneuver for the left posterior canal.

The description of the reverse Epley maneuver for treating right-sided anterior canal BPPV, adapted from Korres and colleagues (Korres et al. 2010), is as follows:

1. The patient is sitting in a neutral position, and then turns the head 45 degrees toward the patient’s unaffected (left) side.
2. The patient lies down, with the head hanging 30 degrees off the edge of the table, still turned 45 degrees toward the patient’s unaffected (left) side.
3. The patient rotates the head toward the patient’s affected (right) side, achieving a position in which the patient’s head is rotated 45 degrees toward the patient’s affected (right) side, while still hanging 30 degrees below the level of the table.
4. The patient rotates the body and head toward the patient’s affected (right) as far as is needed to achieve a position in which the patient’s nose is pointing 45 degrees between the earth’s surface and the ground.
5. The patient is brought back up to a neutral seated position.

Reverse Epley maneuver, right anterior canal, videos

• https://www.youtube.com/watch?v=3xXG0sjdZlU
• https://www.youtube.com/watch?v=lBJC5i5LNbo (Dr. Michael Teixido)

References