In the event of a positive Hallpike or Sidelying test an Epley manoeuvre should ideally be performed. This involves:
- Placing the patient in the provoking position as per the Hallpike test with the head:
- turned left if the left Hallpike was positive, and
- turned right if the right Hallpike was positive
- Wait until any symptoms have fully resolved (and at least 1 minute)
- Then turning the head to 45 degrees the other way and wait 1 minute
- The patient is asked to roll onto their side (in the direction their head is turned) keeping their head looking over their shoulder so they should be looking at the floor. This will often bring on further vertigo and this is a good sign that the treatment will work.
- This position should once again be held for 1 minute.
- The patient is then asked to sit up on the side of the bed facing the direction they were lying with their chin on their chest. They can also get vertigo on this movement so keep them still for at least a minute.
For the rest of the day they should avoid tipping their head up or bending forward and not lie down horizontal until bedtime.
Please see the NHS Lothian video on the Epley manoeuvre.
If any training is required beyond the instructional videos, please contact the Audiology department who will be happy to do this.
C.M. & R.R. 14-07-25
