Benign paroxysmal positional vertigo
September 11, 2021 2:05 AM   Subscribe

Looking for people's experience of benign paroxysmal positional vertigo. My sister had this for about three months nine years ago; it has recurred in the last couple of weeks and is intermittently quite disabling. We can see from looking online that there are some movement treatments which she didn't know about last time (Epley and Semont). Interested in whether these have worked for people and whether there is anything else she could try. Thanks. (Posting with her permission.)
posted by paduasoy to Health & Fitness (18 answers total) 10 users marked this as a favorite
 
Best answer: Oof, three months, that would have been horrible. I’ve had it twice, both times the Epley resolved it in the doctor’s office — I tried doing it at home and it didn’t work, I needed a medical professional to help me through it. Worked pretty much instantly.
posted by third word on a random page at 2:19 AM on September 11, 2021 [2 favorites]


Best answer: My experience was similar to third word’s - instant relief from assisted Epley at the doctor’s office.

There are a few other questions about BPPV/Epley/etc. - see here, and here, for example.
posted by mskyle at 3:42 AM on September 11, 2021


Best answer: The only thing I tried for mine was the Broken Table exercise, and it helped me tremendously.
posted by davcoo at 4:32 AM on September 11, 2021


Best answer: I have some vertigo issue, which may not be BPV (the jury is out). I find doing the Eply at home is often helpful, especially in the morning when I’m first getting up. It’s not permanent relief, but it helps.
posted by GenjiandProust at 5:16 AM on September 11, 2021


Best answer: Had it once, for about a week. It's horrible - I feel for your sister. In my case, a doctor tried Epley and it was ineffective. That said, it's easy to do, and no harm done if it doesn't work, so she should give it a try.
posted by NotMyselfRightNow at 5:37 AM on September 11, 2021 [1 favorite]


Best answer: My wife swears by the half-somersault maneuver developed by Dr. Carol Foster of the University of Colorado School of Medicine. It has been very effective in resolving her BPPV.
posted by Snerd at 6:12 AM on September 11, 2021 [1 favorite]


Best answer: The thing is that there are several different variations of the maneuvers, and which one is appropriate depends on exactly where the crystals are in your ear. The Epley maneuver treats the most common type of BPN (crystals in the posterior semicircular canals), but if that's not where yours are, it might not work. A doctor can help your sister figure out whether a different maneuver will work for her. I went to an ear/nose/throat specialist.

And if she hasn't seen a doctor for this recent iteration, she really should, just to make sure her symptoms aren't being caused by something else.

This really sucks, and I hope it's resolved soon.
posted by FencingGal at 6:24 AM on September 11, 2021 [5 favorites]


Best answer: I'm just here to add that when I had this, I was sent to a physical therapist for the Epley, which worked. I just mention it as another place someone might get help.
posted by Orlop at 6:28 AM on September 11, 2021


Best answer: Epley is what I learned and is highly effective if done right. It can induce really intense vertigo and nausea for those 30-60 seconds though, so having an assistant (friend/doctor) to keep you in position is important. The other trick is that you have six semicircular canals (three per ear) oriented at right angles to each other. Most debris goes into the posterior canal, which is what the Epley works on, but picking the side, left or right, is a coin flip unless you know how to test for and interpret nystagmus. ENTs, neurologists, and vestibular physical therapists can all help with this.
posted by basalganglia at 6:50 AM on September 11, 2021 [2 favorites]


Best answer: I am not a doctor, nor is this doctor's advise. Consult your own medical care professional for diagnosis and treatment.

My husband had BPPV for several weeks in Jan/Feb 2019 before seeing his primary care physician. They ruled out a few things and sent him to an ear/nose/throat specialist, which took two more weeks.
What finally worked was "Epley maneuver with tapping of the mastoid process," done in the examining room. The follow-up recommendation was to keep the head stable for 48 hours, with a towel or pillowcase around the neck if needed. He was instructed that for the next several days he should avoid sleeping horizontally or moving the body in positions that could stir up the crystal deposits in the inner ear again.
He has had reoccurrences over the years and has returned for further treatments, which have solved the dizziness each time.

I jokingly said I would need a doctor's letter to do this maneuver for him at home. We laughed, but the physician taught me how to tap firmly on the mastoid process behind the ear for three minutes per position.
Several articles online have been either inconclusive or dismissive of the tapping, but it has been used each time for my husband and it works better than just doing the Epley maneuver by itself.
This episode of The Doctors shows the physician briefly tapping the mastoid process (6:36) as part of the treatment of one of the program's regular doctors.

One more thing: there are two ears and three canals per inner ear, so realigning the crystal deposits may be more difficult.

Waiting it out did not work for my husband. He was relieved that after one treatment he could get back to normal.
posted by TrishaU at 7:25 AM on September 11, 2021


Best answer: My husband's BPPV was not entirely relieved through the usual movement treatments, so his doctor also recommended that he correct a Vitamin D deficiency as an additional support to his recovery. That did the trick, in conjunction with the maneuvers.
posted by merriment at 12:23 PM on September 11, 2021


Best answer: I've had it intermittently throughout most of my life, and some of the attacks have been really horrible and debilitating. The Epley has helped a lot but I've also learned a number of other smaller head exercises from the doctor, which I'm able to do when I feel like things might get wonky again (head circles, turning my head, etc.). It's definitely helpful to see a professional about this, and they might have some additional materials to give you that can boost the success of the maneuver.
posted by kitten kaboodle at 1:45 PM on September 11, 2021


Best answer: I couldn’t learn to do the Epley properly on my own, but the half somersault recommended above fixes me right up whenever I have an attack now. But my first attack really took about a month to resolve and it was MISERABLE.
posted by congen at 4:28 PM on September 11, 2021


Best answer: Epley is what I learned and is highly effective if done right. It can induce really intense vertigo and nausea for those 30-60 seconds though, so having an assistant (friend/doctor) to keep you in position is important.

Same for me. It's sometimes helpful to do it with someone and there are a few good apps you can get on your phone that can make sure you are doing it correctly which can explain it and keep time for you. The hardest part, for me, was the "Keep your head in this position even if you feel super dizzy/nauseated" but I got some decent relief with it. I get vertigo maybe once or twice a year and the first time I had it for a few days and now since I've been doing the exercises at the first sign of dizziness, it has never lasted as long since.
posted by jessamyn at 6:37 PM on September 11, 2021 [1 favorite]


Response by poster: This is all incredibly helpful, thank you all. And yes, she is urgently trying to get a doctor's appointment, but having some difficulties as the surgery is not coping with demand.
posted by paduasoy at 1:33 AM on September 12, 2021


I just had my first encounter with it this week and wow, it's miserable! A video chat with a physician taught me about the Epley and Foster maneuvers, but none of the easy-to-find online information explained that there can be a still-awful "settling" period after doing the motions. (I found that later in this scientific deep dive into BPPV: https://www.hindawi.com/journals/aoto/2014/792635/.) I was glued to my toilet, feeling like I had to puke for literally hours after, certain it but work, but then the next day I woke up and the dizziness was nearly all gone. Highly recommend sleeping with a travel pillow around the neck, too. Good luck!
posted by foxtongue at 7:44 AM on September 12, 2021 [1 favorite]


Assisted Epley in a doctor's office worked for me.
posted by bedhead at 8:03 AM on September 13, 2021


My husband got his fixed by an Occupational Therapist after a few neurologists etc. tried and failed. He doesn't remember what the technique the OT used was called -- he said it was similar to the Epley maneuver but not Epley. He just looked on WebMD and from the description thinks maybe it was Brandt-Daroff.

I recommend seeing an OT as they have a lot of really specialized knowledge about improving balance that even neurologists don't know.
posted by Jacqueline at 8:32 PM on September 13, 2021


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