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BPPV and Epley manoeuvre The Epley manoeuvre is a highly effective treatment for Benign Paroxysmal Positional Vertigo (BPPV), the most common cause of vertigo. (By way of explanation, the word benign means good i.e. not harmful; paroxysmal means sudden attack; positional means it only occurs on certain movements; and vertigo means to turn i.e. it is the illusion of movement.) It is often worse in the act of lying down, turning over in bed, getting up from a lying down position, or when looking up. BPPV is a disorder of the inner ear, and arises when a tiny crystal