Treatment for BPPV, posterior canal, right side, modified Epley maneuver

By Marcello Cherchi, MD PhD

The modified Epley maneuver for treating posterior canal BPPV was described by Gan and colleagues (Gan et al. 2021).

The Figure below, adapted from Gan and colleagues (Gan et al. 2021), shows the modified Epley maneuver for treating right-sided posterior canal BPPV.

Figure: Modified Epley maneuver for treatment of right-sided posterior canal BPPV. Adapted from Gan et al. (Gan et al. 2021)
Figure: Modified Epley maneuver for treatment of right-sided posterior canal BPPV. Adapted from Gan et al. (Gan et al. 2021)

The modified Epley maneuver for treating right-sided posterior canal BPPV can be described as follows:

  1. (A1) The patient starts in a neutral seated position, then (A2) turns the lead 45 degrees toward the affected (right) side.
  2. Maintaining the head turned 45 degrees toward the affected (right) side, the patient lies backward on to a pillow placed beneath the shoulders, with the neck extended about 20 degrees posteriorly (such that the head is below the level of the shoulders). This position is maintained for 30 seconds.
  3. Maintaining the torso in this position, the patient turns the head 90 degrees toward the unaffected (left) side, such that the head is rotated toward the unaffected (left) side, half-way between the sagittal and coronal planes (which in this position will be half-way between the sky and the surface of the earth). This position is maintained for 30 seconds.
  4. The head and body are both rotated en bloc by 90 degrees toward the unaffected (left) side into a side-lying position, with the head still rotated 45 degrees toward the unaffected (left) shoulder, but also with head propped up such that the neck is laterally flexed toward the affected (right) side. This position is maintained for 30 seconds.
  5. The patient sits up, with the head inclined forward by 30 degrees.

Modified Epley maneuver, right posterior canal, videos

  • [As of this writing, no videos had been identified that illustrate this maneuver with sufficient clarity.]

References

Gan Z, Zhou S, Yang H, He F, Wei D, Bai Y, Wang Y, Wang Y, Fu W, Han J (2021) Self-Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Preliminary Study. Front Med (Lausanne) 8: 654637. doi: 10.3389/fmed.2021.654637

Page first published on February 28, 2025. Page last updated on March 8, 2025

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