Abstract Details

Title John McNaughton Epley: His Life and Theory That Challenged Convention in the Study of Benign Paroxysmal Positional Vertigo

Topic History of Neurology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 11-002

Objective

To explore the life and contributions of John McNaughton Epley, with a particular focus on the development of the Epley maneuver and its impact on the treatment of benign paroxysmal positional vertigo (BPPV).

Background BPPV is a common vestibular disorder characterized by brief episodes of vertigo, due to dislodged otoconia within the semicircular canals. Despite being well characterized, BPPV's pathophysiology was poorly understood until the mid-20th century. Epley challenged the prevailing cupulolithiasis theory with his canalithiasis theory, leading to the creation of the canalith repositioning maneuver—now known as the Epley maneuver—which revolutionized the treatment of BPPV.

Design/Methods A literature review was conducted on PubMed and Google Scholar to outline Epley’s life and trace the development of the Epley maneuver, drawing from personal interviews, published papers, and historical articles. The research emphasizes Epley’s persistence in refining the procedure and his eventual recognition in the field of vestibular medicine.

Results Epley's early exposure to vestibular medicine during his internship and his subsequent private practice led him to explore solutions for BPPV. Epley first introduced the canalith repositioning maneuver in 1980 but faced skepticism and rejection from the medical community, particularly due to the prevailing cupulolithiasis theory. Despite setbacks, his 1992 study demonstrated a 100% success rate in 30 patients. By 1999, the Epley maneuver was formally recognized in the New England Journal of Medicine as the recommended treatment for BPPV.

Conclusions Epley’s contributions to the understanding and treatment of BPPV through the development of the Epley maneuver have become foundational techniques in general neurology. His work is a testament to the value of challenging existing theories and has, since, shaped modern neurological practice.

Authors/Disclosures
Lisa Ramirez, MD PRESENTER	Miss Ramirez has nothing to disclose.
Brendan Huang, MD (Northwell Health)	Dr. Huang has nothing to disclose.
Jeffrey M. Katz, MD (North Shore University Hospital)	Dr. Katz has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Katz Medical Consulting. The institution of Dr. Katz has received research support from Medtronic.

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