Following treatment, a small number of patients will feel a bit dizzy and off-balance, occasionally for a day or two. The manoeuvre is safe and can be carried out on anyone without severe neck or back problems, which would not necessarily prevent treatment but would need to be carefully assessed beforehand. This is not a major problem: the manoeuvre can be repeated as and when necessary, and in some cases, patients (or their relatives) can even be taught to do it themselves. Up to a third of patients may suffer one or more further bouts of BPPV at some time in their lives. They may however remain free-floating and liable to fall back into one of the semi-circular canals. Once there, they may reattach themselves, or possibly dissolve. This manoeuvre floats the chalk crystals round the affected canal and out of the far end, back to where they belong. The patient is then rolled over (in stages, pausing for about half a minute in each position) onto the opposite side (nose towards the floor), before being sat up again. The Epley manoeuvre begins by making the patient dizzy with the appropriate Hallpike Test. The Epley manoeuvre is used to treat the commonest type of BPPV, where the chalk crystals are free-floating in the posterior ear canal.
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