If you suffer from benign paroxysmal positional vertigo (BPPV), the effects can be frightening. The condition causes a spinning, rotational dizziness, often accompanied by severe nausea. This can last from a few seconds to a few minutes. During this time it may be difficult to read or see, due to a visual disturbance called nystagmus. Anti-vertigo medications are available, but in many cases the Epley maneuver can be the optimal treatment. Before we examine the treatment itself, let’s take a look at BPPV.
What Causes Benign Paroxysmal Positional Vertigo?
Vertigo is a common complaint in the United States, and around 6 million sufferers seek clinical treatment every year. There are many causes of vertigo, some include the inner ear. The labyrinth of the inner ear contains crystals that are known as otoliths. Occasionally these crystals can become dislodged from their usual position, and move to the semi-circular canals. This causes fluid displacement within the ear, which in turn leads to the condition known as BPPV or vertigo. Sometimes the inner ear can become infected and vertigo results. This is a separate condition known as labyrinthitis.
What Triggers A Vertigo Attack?
The otolith movement that leads to BPPV is usually triggered by a sudden head movement. This can result from a head trauma, or from something as simple as tilting the head, or rolling over in bed. Patients often report that one of the most common triggering movements is looking upwards. There may be other contributing factors, including stress, lack of sleep, or dehydration.
Repositioning The Crystals Through The Epley Maneuver
As the effects of BPVV are caused by the dislocation of crystals from the labyrinth of the ear, one of the most effective ways to treat the condition, is to reposition them. This can be done by a qualified practitioner using the Epley Maneuver. This involves the patient being placed into specific positions that will allow gravity to reposition the crystals correctly. Here is the sequence of movements:
- The patient sits upright, with legs out, and the head turned to the affected side.
- The patient is forced quickly downwards, with the neck extended and the ear facing the ground.
- After around 2 minutes, the head is turned 90 degrees.
- After another 1-2 minutes the patient rotates another 90 degrees, so that they are now facing downwards at a 45 degree angle. The head is kept in the same extended position.
- After another 1-2 minutes, the patient is slowly brought into a sitting position. This is held for around 30 seconds, with the head still at the 45 degree angle.
This sequence can be repeated two to three times if necessary, but should only be initiated by a highly trained and qualified practitioner located in Princeton. The practitioner will monitor the patient throughout. Sometimes, the patient may experience dizziness and the effects of vertigo during the Epley maneuver. After the Epley Maneuver, patients are typically instructed to avoid rapid head movements.