Dr John M Epley, an Ear, Nose and Throat specialist changed the course of history and made an enormous difference to the lives of people suffering Benign Paroxysmal Positional Vertigo (BPPV), the most common inner ear disorder which causes random, recurrent, and abrupt episodes of vertigo (an illusion or hallucination of movement) for which there had been no satisfactory treatment.
He proposed the Particle theory and the treatment of BPPV, namely the Epley Manoeuvre (Canalilthiasis Re-positioning Manoeuvre) which repositions the particles (otoconia) in the semicircular canal into the utricle using gravity.
The video you are about to view is rare, and has surfaced on the Dr John M Epley profile page on the site, Life In The Fast Lane.
It captures Dr John Epley explaining how he developed the Particle Theory and the Canalilthiasis Repositioning Manoeuvre (CRM) to treat BPPV that replaced the Habituation Theory on which the Brandt Daroff exercises were predicated.
The Epley Manoeuvre as BPPV treatment
Although, BPPV is benign, the consequences of this disorder are NOT!
BPPV is a major cause of falls in the older population, often resulting in life-threatening injuries, loss of independence, fear of falling and social isolation. BPPV is all too often neither diagnosed nor managed correctly. The Dix-Hallpike and Supine Roll manoeuvres are the international gold standard diagnostic tests for BPPV using infra-red video Frenzel goggles to prevent visual fixation.
The clinician must determine:
- The vertigo is caused by BPPV because there are central pathologies which mimic peripheral BPPV and upper cervical problems which cause dizziness/light headedness
- The ear and semicircular canal(s) affected. Most often it is one ear and one semicircular canal
- The treatment of the semicircular canal(s) using a CRM in the plane of the canal
- Follow-up the patient ONE-week post-treatment and repeat the diagnostic tests. This is the only objective measure to ensure the BPPV has resolved
Dr John M Epley was my mentor and I hope this video will help shine a light on the signficance of his work and inspire you to encourage friends, family members, or patients experiencing random, recurrent, and abrupt episodes of vertigo, to seek diagnosis and treatment.