This might give the wrong impression that the Epley maneuver is the cure for all BPPV. Misdiagnosing which semicircular canal is affected, typically by confusing horizontal and diagonal nystagmus, or simply ignoring the identification of the affected canal, results regularly in no cure. Using the appropriate maneuver for the affected canal is essential. The maneuvers are uncomfortable for the patient as they induce strong vertigo and the patient might resist performing them. If the maneuver is not uncomfortable then most likely the wrong maneuver has been selected by a misdiagnosis of the affected semicircular canal. All the maneuvers consist of a series of steps in which the head is held in a specific position, typically for 30 to 60 seconds until nystagmus stops. Movement from one position to the position of the next step has to be done fluently to give the particles enough momentum to move. A position has to be held until nystagmus has completely resided, which indicates that the particles have stopped moving, before one proceeds to the next step. Epley maneuver
The Epley maneuver employs gravity to move the calcium crystal build-up from the posterior semicercular canal ( resulting in diagonal nystagmus ) that causes the condition. This maneuver can be performed during a clinic visit by health professionals, or taught to people to perform at home, or both. Postural restriction after the Epley maneuver increases its effect somewhat.When practiced at home, the Epley maneuver is more effective than the Semont maneuver.
Hyperlipidemia is abnormally elevated levels of any or all lipids (fats, cholesterol, or triglycerides) or lipoproteins in the blood. The term hyperlipidemia refers to the laboratory finding itself and is also used as an umbrella term covering any of various acquired or genetic disorders that result in that finding. Hyperlipidemia represents a subset of dyslipidemia and a superset of hypercholesterolemia. Hyperlipidemia is usually chronic and requires ongoing  medication to control blood lipid levels.Lipids (water-insoluble molecules) are transported in a protein capsule. The size of that capsule, or lipoprotein, determines its density. The lipoprotein density and type of apolipoproteins it contains determines the fate of the particle and its influence on metabolism. Hyperlipidemias are divided into primary and secondary subtypes. Primary hyperlipidemia is usually due to genetic causes (such as a mutation in a receptor protein), while secondary hyperlipidemia arises due to other underlying causes such as diabetes. Lipid and lipoprotein abnormalities are common in the general population and are regarded as modifiable risk factors for cardiovascular disease due to their influence on atherosclerosis. In addition, some forms may predispose to acute pancreatitis. Classification
Hyperlipidemias may basically be classified as either familial (also called primary) when caused by specific genetic abnormalities or acquired (also called secondary) when resulting from another underlying disorder that leads to alterations in plasma lipid and lipoprotein metabolism. Also, hyperlipidemia may be idiopathic, that is, without a known cause.Hyperlipidemias are also classified according to which types of lipids are elevated, that is hypercholesterolemia, hypertriglyceridemia or both in combined hyperlipidemia.