John Epley

Biography

• Born on Feb. 8, 1930 in Klamath Falls, Oregon
• 1957 – graduated from UO Medical School
• 1958 – internship at Jackson Memorial Hospital, Coral Gables, Florida
• 3 years as a Captain heading the ENT Department at Vandenberg Air Force Base
• 1965 – completed surgical residency at Stanford Medical School
• 1979 – original Particle Theory for Benign Paroxysmal Positional Vertigo (BPPV)
• 1996 – Oregon Board of Medical Examiners notified Epley that he was under investigation for alleged unprofessional conduct – later dismissed in 2001
• 2009 – retired aged 79 after suffering a severe stroke
• Died July 30, 2019

Medical Eponyms

Epley maneuver (1980)

A particle repositioning maneuver for the treatment of BPPV – with the aim of moving the canaliths out of the posterior semicircular, back into the utricle. It has been shown to be safe and effective at resolving BPPV in 50-85% of cases (2014, 2013).

The original maneuver was first described by John Epley in 1980 also involved vibrations over the mastoid during the maneuver. Today the Modified Epley is performed without the vibrations.

See the Epley maneuver page for details on how to perform it and an original video produced by John Epley himself.

Key Medical Contributions

Epley published his original Particle Theory for Benign Paroxysmal Positional Vertigo in 1979 outlining the theory of cupulolithiasis in the posterior semicircular canal as the pathophysiological mechanism of the condition. A theory that has since been further demonstrated and widely accepted.

Hypotympanotomy retractor (1979). A retractor designed to allow an inferior oriented approach to the middle ear such as in posterior ampullary nerve transection, the trans-cochlear approach to the internal auditory meatus or glomus tympanicum resection.

Major Publications

• Epley JM. Modified technique of iontophoretic anesthesia for myringotomy in children. Arch Otolaryngol. 1977;103(6):358-360.
• Epley JM. Air-caloric delivery tube adapter. Otolaryngology. 1978;86(6 Pt 1)
• Epley JM. Hypotympanotomy retractor. Otolaryngol Head Neck Surg. 1980; 88(4): 470-471.
• Epley JM. New dimensions of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1980; 88(5): 599-605.
• Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992;107(3):399-404.
• Epley JM. Positional vertigo related to semicircular canalithiasis. Otolaryngol Head Neck Surg. 1995;112(1):154-161.
• Epley JM. Particle repositioning for benign paroxysmal positional vertigo. Otolaryngol Clin North Am. 1996;29(2):323-331.
• Epley JM. Human experience with canalith repositioning maneuvers. Ann N Y Acad Sci. 2001; 942: 179-191.

Controversies

Epley faced over a decade of scepticism and ridicule from peers in his field who did not believe in his repositioning manoeuvre. This led to colleagues questioning his medical skills in general and in 1996 The Oregon Board of Medical Examiners notified Epley that he was under investigation for alleged unprofessional conduct. It was not until 2001 that these claims were finally dismissed.

Physicians learn to just do the routine, to do the accepted things — don’t go too far out. They’ve got so much to lose if they stick their neck out

Epley

References

Biography

• Obituary: John McNaughton Epley M.D. Dignity Memorial.

Eponymous terms

• Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169(7):681-693.
• Radtke A et al. Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure. Neurology. 2004; 63(1): 150-152.
• Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G. Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurootol. 2013;18(2): 83-88
• Hilton  MP, Pinder  DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database of Systematic Reviews 2014; 12: CD003162.
• RojasBurke J. Epley maneuver for vertigo was invented by Oregon doctor. The Oregonian. October 2019

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