BPPV? What's that?

Benign paroxysmal positional vertigo (BPPV) is a form of dizziness thought to be due to loose debris floating within the inner ear canals. it is typically brought on by changes in head positions such as rolling over in bed, looking up, or bending over.  Dizzy episodes typically lasts for seconds to minutes.  There may be associated nausea and a "hangover" type feeling which may last for several hours or days.  This type of vertigo has no impact on hearing. BPPV is sometimes associated with damage from head injury, infection, or changes from advancing age.

Office Treatment

If you had been diagnosed with BPPV, there is a simple, effective treatment that can be performed in the office. The Epley maneuver, named for the doctor who developed this technique, is the most effective means of resolving BPPV.  Each position in this maneuver progressively moves particles from an area within the inner ear which provokes dizziness to a harmless area. It is a simple and painless procedure which only takes 10 to 15 minutes to complete.

Can I do the Epley maneuver at home? 

Some patients can learn to do this maneuver at home, making self-treatment possible.  Caution is advised, however, as an incorrect sequence of movements can make the vertigo worse. 

When do I need to be re-evaluated after treatment?

Most patients are seen one week after initial treatment for repeat testing. A cure rate of 80-90% is common after a single treatment. If vertigo is provoked by repeat testing, then treatment with the Epley maneuver is indicated.  The instructions following office treatment should once again the followed. 

Instructions following office treatment

Once the maneuver has been performed is very important keep the head as upright as possible for the next 48 hours.  This will allow time for the particles to settle in an area of the inner ear that does not stimulate vertigo.  Try to avoid quick movements, bending forward or backward, or sleeping in a flat position.  This means that you must sleep with your head no lower than a 45° angle for two nights following the procedure.  This is most easily accomplished in a reclining chair or by using pillows on the couch.

Following the initial 48 hour period, you should still avoid provoking the vertigo for at least one week.  Use two pillows when you sleep, avoid sleeping on the affected side, and don't make quick head turns.  These instructions are aimed at reducing the chance that loose particles may fall back into the sensitive portion of the inner ear and provoke vertigo.

Approximately 1 week after treatment, normal activities may be resumed with caution.