Through rotating the head and tilting the body in a series of precise movements, the Epley maneuver removes calcium crystal debris from the semicircular canal of the ear and returns it to the inner ear, where it no longer produces symptoms, reports WebMD. Under normal conditions, the calcium crystal debris of the inner ear moves with the body to help people maintain their balance.
In benign paroxysmal positional vertigo, which is usually brought on by infection or inflammation of the inner ear, the calcium crystal debris no longer moves normally, and it often slips into the ear's semicircular canal, according to WebMD.
When performing the Epley maneuver, the doctor or physical therapist rotates the patient's head horizontally, 45 degrees in the direction of the affected ear, notes WebMD. Maintaining this position of the head, the doctor then tilts the patient into a lying position. In this position, the calcium crystal debris moves to the apex of the canal and may result in an attack of vertigo, which usually passes within a minute. The patient's head is then rotated 90 degrees in the direction of the unaffected ear, which may result in another attack of vertigo as the calcium crystals move farther along the ear canal and back into the inner ear. Once the vertigo passes, the doctor returns the patient to a seated position.
Benign paroxysmal positional vertigo symptoms may be cured or improved in only one treatment with the Epley maneuver, though multiple treatments may be necessary, explains WebMD. Doctors and physical therapists may instruct patients to perform a modified version of the Epley maneuver at home if they feel comfortable doing so.