Dizziness The American Journal of Medicine Gregory T. Whitman, MD  The American Journal of Medicine  Volume 131, Issue 12, Pages 1431-1437 (December 2018) DOI: 10.1016/j.amjmed.2018.05.014 Copyright © 2018 Terms and Conditions

Figure A modified Epley maneuver for the treatment of left posterior semicircular canal benign paroxysmal positional vertigo. The head is turned 45° toward the left (A); then the patient reclines back with the head still turned left (B), and this position is maintained for approximately 30 seconds. If nystagmus is observed, the patient turns the head 90° toward the right side (C) while maintaining neck extension. The head-hanging-right position is then maintained for approximately 30 seconds. Next, the patient is turned further toward the right, into a side-lying position, such that the head is turned in the same direction, 90° beyond its last position; the nose should then be pointing in a direction that is about halfway between parallel and perpendicular to the floor (not shown). After approximately 30 seconds, the patient sits up. For the treatment of the right posterior canal variant, this procedure is followed with the modification of exchanging the words right and left. Treatments of the horizontal and anterior canal variants are outside the scope of this review. The American Journal of Medicine 2018 131, 1431-1437DOI: (10.1016/j.amjmed.2018.05.014) Copyright © 2018 Terms and Conditions