The patient is held in the right head hanging position (step 2) for 20−30 seconds, and then in step 3 the head is turned 90 degrees toward the unaffected side. If BPPV is present, nystagmus ensues usually within seconds. The patient is placed in the upright position with the head turned 45 degrees toward the affected ear (step 1) and then laid back quickly to a position with the head extended below the shoulders (step 2). The Epley maneuver for right-sided benign paroxysmal positional vertigo (BPPV) This study was classified as not regulated research from the institutional review board of the University of Michigan. Videos were excluded if they exclusively demonstrated other variants of BPPV treatment (e.g., the Semont maneuver) or the maneuver was considered a substantial deviation from the standard EM ( figure). Videos were eligible if they demonstrated the entire EM. The search was supplemented by also reviewing the list of featured videos that accompany search results. From the list of results, videos relevant to BPPV were selected for viewing based on their title and the video snapshot provided in the search results list. Search terms were the following: Epley, Epley maneuver, canalith repositioning maneuver, benign paroxysmal positional vertigo, benign positional vertigo, BPPV, and BPV. No beginning date cutoff was used, and the last date of the search was August 30, 2011. YouTube ( ) was searched for videos that contained a demonstration of the EM. From the videos identified, we aimed to 1) describe and analyze the video content, 2) determine how easily the videos could be found using generic search terms, and 3) assess posted comments for themes regarding the use of the videos. In this study, we performed a systematic search for all videos available on YouTube that demonstrate the EM. As a result, video instruction on the EM is now available to both providers and the general public. 2 Soon after, the video was uploaded to YouTube by a lay person ( ). 6 In 2008, an EM video was published by the American Academy of Neurology's Practice Parameter on BPPV. Video-sharing Web sites, the most popular of which is, are now a resource for how-to videos for common medical problems. However, the EM is substantially underused in routine clinical care. 2, 3 The maneuver is simple and performed at the bedside in a matter of minutes using a series of positions designed to move the particles out of the canal. 1 The Epley maneuver (EM) (i.e., the canalith repositioning maneuver) is a highly effective treatment supported by 2 evidence-based guidelines. Benign paroxysmal positional vertigo (BPPV) is caused by freely moving particles (i.e., canaliths) trapped in a semicircular canal of the inner ear.
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