Epley
maneuver performed at the bedside at this time.
Patient initially placed in seated position with legs fully extended and
the head rotated 45° to the [right/left same side as positive
Dix-Hallpike]. The patient was then
quickly lowered into a supine position with the head held approximately in a
30° neck extension with the head still rotated to the [right/left]. The patient was noted to have [no
horizontal/vertical] nystagmus with this movement, suggestive of the 'primary
stage' of the maneuver. The patient was
left in this position for 1-2 minutes.
The patient's head was then rotated 90° in the opposite direction with
the neck still approximately in 30° of extension. The patient was left in this position for 1-2
minutes. Keeping the head in this fixed
position, the patient rolled onto their shoulder with the head rotated 45° in a
downward position, and was noted to have [no horizontal/vertical] nystagmus,
suggestive of the 'secondary stage' of the maneuver. The patient remained in this position for 1-2
minutes. Finally, the patient was slowly
brought to an upright sitting position, while maintaining the 45° rotation of
the head, and remained seated for 30 seconds.
The patient reported [no
significant/minimal] improvement in vertigo at the end of the procedure.
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