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Normally only with head movement does fluid within the inner ear also move informing the brain that a head turn occurred. However should a crystal called an otolith gets displaced into the posterior canal of the inner ear, BPPV dizziness occurs. Fluid movement occurs due to the crystal rather than head turns causing the brain to think movement has occurred even though none has happened. When the Epley maneuver is performed to treat this posterior canal BPPV by trying to get the loose crystal out of the canal, this maneuver is started by turning the head forty-five degrees and the body laid back such the head is extended about 20 to 30 degrees. The direction of this initial head turn is formally determined by the Dix-Hallpike maneuver. That said, the initial head turn is typically towards the side that more severely triggers the dizziness. If BPPV is present, eye twitching call nystagmus will occur. After 30 to 60 seconds the head is turned 90 degrees to the
