How to Prevent BPPV from Recurring (Vertigo)
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- เผยแพร่เมื่อ 4 ก.พ. 2024
- If you've had BPPV before, you'll want to do everything you can to keep it from coming back!
BPPV, also known as Benign Paroxysmal Positional Vertigo, occurs when little crystals called "otoconia" float into the inner ear canals from an adjacent inner ear organ.
The result can be very uncomfortable and sudden vertigo.
For some people, effectively treating the BPPV once with the Epley Maneuver and/or the Gufoni Maneuver will be enough to keep the vertigo from coming back.
But for others, the vertigo can recur, sometimes frequently.
In this video, I'll answer some common questions I get from viewers about how to prevent BPPV from recurring, and I'll also share 3 tips to help minimize the vertigo from coming back in the first 24-48 hours.
If you've had success treating your vertigo or preventing it from coming back after treatment, please share your story below!
- Luke Gordon, DPT
Doctor of Physical Therapy/Owner of Gordon Physical Therapy
www.gordonphysicaltherapy.com...
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My first episode was just over year ago. Horrible feeling that i obsessed over and fear everyday! I saw neurologist and diagnosed BPPV. He used Eppley maneuver and it did stop the dizzyness. I used maneuver with success. Several months later I had recurrence, went to Dr., labs done. My Vitamin D was Very LOW. I started supplements. I believe my symptoms and recurrence has diminished since taking Vitamin D.
I dealt with vertigo for 6 weeks….it was horrible and I was working with my PT using the epily maneuver ……it helped but it didn’t go away…I started doing some extensive research….I’ve always been a huge Edgar Cayce fan…..he recommended water hydration…….within 2 days of drinking at least 72oz of filtered water daily it was gone. I’ve continued to stay hydrated and haven’t had another reoccurrence. For anyone suffering……what do you have to loose…..water is free and it helps to thin the viscosity of the fluid in the canals.
That's an excellent piece of advice! Thank you for sharing!
Ty for sharing
Ty!
You articulated my post acute vertigo sensations perfectly, i.e., after a vertigo event, medium to fast vertical head motions cause moderate dizziness/nausea. Continued vertical head motions bring back full blown vertigo attacks.
Thank you for sharing. I need to start drinking more water. 👍🏻 😊
Thanks for this video. I was diagnosed with BPPV in 1998 and it has recurred at times ever since.
You're welcome!
Thanks for the tips. I had BPPV 6 months back. My son is a doctor at Mayo Clinic. I was super nervous thinking I have some serious disease with my head spining. He mentioned to me “Mummy don’t worry it’s BPPV- I then looked for the answers myself thanks TH-cam and Google. I did Epley and got rid of spinning head.
Now I got the recurrence again. Not as pronounced but not good feeling. I am thankful to you for “what not to do” I was thinking that my neck may be the culprit- so rotated my neck. That’s going to stop. I have adjustable bed so will incline tonight.
Thank you long haired help sitting somewhere!!
Glad this helped! Good luck in the future!
I only have this problem as I'm waking up. Thankfully not very often. But it hit me hard this morning and scared me to death! All I did was start waking up and rolling over. My head was a spinning top and I freaked out screaming. It stopped when I laid on my back for a few seconds. I have a lot of migraines and ear ringing.
Same!! This is terrible
That sounds awful! Have you tried to diagnose it yet with the positional tests?
No but it hasn't happened since. I think I just woke up too fast and my body took longer to catch up with my brain. Another weird thing that's happened was me realizing when I was half asleep one time I'd left the heater on and running out to turn it off. As I got up to it suddenly I couldn't move and felt frozen when I got to it. Then my heart started pounding and I had to go back to bed or I would have had another episode. This happens Everytime I get up before my body is ready.
I was exercising woke up next day with mild dizziness when I moved. Last Sunday I laid on my right side and had 2 vertigo attacks first one stopped after I got up and second lasted 6 hours with inability to walk and being sick. I ended up at the hospital was given fluids and zofran which helped the sickness and was diagnosed with bvvp. Fast forward this week I went to see my doctor which she said just keep doing the epley exercises and gave me a nasal spray and ear drops as my ear also pops. On Thursday I had a mini vertigo spell while trying to put the ear drops in and got scared I ended up finding a physical therapist. He performed the epley on me and I had vertigo for about a minute each time. He said that isn't common but to just hold the positions a bit longer. After Thursday I'm having extreme anxiety attacks, dizziness, migraine, brain fog and sickness feeling I also go from feeling like I'm tilting backwards to forwards randomly like at the moment feel like I'm tilting forward even laying down. I tried laying on the effected ear and no vertigo just anxiety so I'm not sure what else to do. I'm scared it won't go away and I'm gonna be stuck like this forever and the sickness makes it hard to eat like at all.
If you found a PT who knows how to treat vertigo, I would go back for a follow up and see what they can tell you. It should help!
Retired physician here...your videos are excellent and your explanations very clear. I wonder if I could ask your opinion this: a patient has documented right post-canal BPPV,,,positive DH test and responded to Epley. Has had several subsequent episodes of transient vertigo with vertical head movements...DH intermittently positive; Epley repeated only when DH positive. But...now has reproducible vertigo (x15sec) after sleeping for an hour with right ear down WHEN moves head to neutral position (so looking straight up while still supine). Nystagmus appears to be up-beating (though difficult to be sure without the goggles etc). Question: Still posterior canal or now horizontal canal?? Tried the diagnostic test for horizontal BPPV and no vertigo or nystagmus... so, confusing... Appreciate your thoughts!
That sounds very confusing... I haven't seen this type of presentation before. With the head in neutral, I definitely wouldn't expect posterior canal involvement, as both canals are flared out at 45 degrees with the head in neutral (no gravitational effects). So I'm wondering if it's horizontal canal BPPV at this point. Have you tried the Supine Roll Test yet? Let me know how this turns out!
My vertigo started immediately after I sat up from doing “plough pose” or Halasana in my yoga class. I have done the same pose many times before without causing vertigo. Coincidence or the probable cause? Will be scared to do it again now. The Epley manoeuvre stopped it though but not till a week later when I luckily discovered your video. Thankyou so much!
I would definitely test for BPPV and then continue treating with the Epley or Gufoni until it resolves. Good luck!
I was told I have Vestibular Neutris. Now 4 months still sometimes feel very off
Few months ago, positive ageotropic horizontal canal in left ear. Did Gufoni 2x and nystagmus stopped. Since then I test negative during supine and dh, but when laying down flat on left side, body and head, I have slow horizontal nystagmus that lasts less than a minute? How do you know what to do now? No nystagmus on right side.
Hi. Thanks for ur video. I had horizontal BPPV. Basically it was in left posterior canel and i thought it was in right and did epely manuer for right and it made the spinning worse and threw up 2 times and didn't eat anything for the whole day.
After 5 days I went to ENT whlo then reffered to a vertigo center where they put up some VR kind of device and did multiple testss ans finally convoluted its left horizontal canel.
They did manuer and it was gone. Noe its been 15 days after the treatment but I still feel dizzy but no spinning.
My question is does BPPV occur because of continuous driving? Im still very nervous Bout turning while sleeping and bending forward.
Also I suggest ppl to just visit an expert to identify the correct canel and get the manuer done there itself instead of self doing as I m still struggling with dizziness even after 15 days
Mine was first diagnosed when I was in my early 30s, about 30 years ago, after I tried to learn jiu jitsu. Turns out doing rolling ukemis is a bad idea when you have BPPV. Heh. After that I have had occasional attacks, most often connected to that rolling over in bed move, but they haven't been particularly common, and I have learned to deal with them. They usually pass by themselves after something like half an hour, if they don't doing those head movements can help.
I have probably have had the tendency at least from a fairly young age, I have, for example, never learned how to ride a bike. I have sometimes wondered if falling off a horse head first may have had something to do with the whole thing. I had a helmet, but since the top of my skull was the first part of my anatomy to make first contact with ground, well... the critter made a sudden stop, yanked its head down and bucked a bit, and the saddle slid a bit forward, and I was trying to hang on to the reins but being just barely over 10 years old at that time that just kind of propelled me forward and over the horse's head. I don't remember being all that dizzy at that time, and I climbed back on after a few minutes, but still... 🤔
Thank you for sharing your story!
I had absolutely no problem with forward rolls - but just a few backward rolls put me in bed for 3 days :(
Is there much benefit in brandt daroff exercises? I have read mixed evidence!
I'm not a huge fan. I've seen them prescribed to treat BPPV, which doesn't seem to do much. After treating BPPV, I prefer VOR exercises, and other dynamic balance exercises.
Hi! All this is very helpful. I see some mention of yoga postures and that some folks have had to quit. I've been doing yoga for five decades and don't want to give it up. What postures should I stay away from, or movements? Thank you so much!
You don't necessarily need to avoid any yoga poses, unless they're causing vertigo (such as Down Dog). If you're able to clear your BPPV and head movements no longer cause symptoms, you should be able to make a full return to yoga. And then just watch out for symptoms in the future and re-treat your BPPV as needed (as recurrence rates are somewhat high).
I recently had a period of vertigo for 2 weeks, the first few days being the worst. The symptoms pointed to BPPV. I’ve seen a physio twice and he did the epley twice. The vertigo has now gone - it was gradually fading over days.
However I still have a ‘whooshing’ in my left ear, slight ringing and it does seem a bit muffled. I’ve had this on and off for a few years. Could it be anything else?
Also now have a cold including laryngitis so don’t know if that’s related!
If you're having auditory symptoms such as whooshing and ringing, you can have something else like Meniere's Disease. I'd recommend seeing an ENT if it keeps bothering you. Good luck!
@@GordonPhysicalTherapy thank you!
I had my granddaughter help to do the Epley after a few weeks of suffering. We watched TH-cam to see how to do it. Yes i threw up on 2 positions but felt slightly better afterwards. It took about another week to recover.
My longest bout was 9 weeks. Couldn't drive, couldn't do anything and kept my head in a certain position to be able to function, any other movement had me nauseas. Saw the neuro, ENT, had scans, but it was finally when the ENT said it could be coming from my neck and I saw a chiro who cracked my neck that i recovered. Chiro though, thought that the sudden movement he performed was similar to an Epley.
I now have a physio on speed dial when it hits. It's a horrible affliction.
I'm glad the chiro was able to help you! Thank you for sharing your story!
Often, restrictions aren't prescribed post treatment due to research not showing it significant being helpful.
Why do you give restrictions? Just curious.
Can flying cause vertigo? Never had this before but the other day after a very early flight I came home and napped and woke up to dizziness and this terrible thing ! Dont want this to happen again! 🙏🏻
How do you know which ear canal is affected? I always sleep on my side
You diagnose the canal and the side with the Dix-Halpike test and the Supine Roll Test.
I thought I had BPPV. It took 6-8 Eppley Manuevers to allegedly get crystals in place. The manuevers were done over the course of three visits. My neurologist said it should never take that many manuevers to clear crystals and that one visit is usually all you need. Thoughts?
Great question! Once in a while, it can take multiple days and Epley treatments to clear the crystals. And other times, it works right away (like a miracle!). So your experience sounds normal to me.
Do you know why some BPPV episodes would clear on their own within a few days? I’ve had episodes on and off since 2014 and a couple of my attacks have disappeared on their own without treatment in 2-3 days
Good question! Two things can happen: sometimes the crystals probably float back to where they belong on their own, and other times it's possible that they dissolve. Those are the theories :-)
Are you diagnosed with BPPV
@@kathleenhowe8134 Yes I am since 2014
Hello,
While taking face massage, vibrator was used on ear by mistake, after that it was felt that liquid inside ear got disturbed.
After taking maneuver done from expert physician,
No spinning happen from last 6 months after sleeping on both ears.
1. Should i consider that issue got resolved?
2. Little imbalance what to do for that?
3. Can I again play cricket or football?
4. This was not agewise ear crystals loosening, it was accidental, will it recur?
It sounds like you just need to do some VOR/gaze stabilization exercises to get your inner ear to function at a higher level. After that, you should be good to return to normal activities, Just be on the watch out for the BPPV to recur, and then treat again as needed.
@@GordonPhysicalTherapy
Thank you so much for your reply.
You are really great
Also forgot to mention I was extremely dizzy everytime the Eppley was performed.
See my other comments... I'm glad it worked in the end!
Is medicines worked like vertigo medicines?
Meclizine 25mg is prescribed for Vertigo..... Urgent Care Centers can write a prescription for this if you can't get to your Primary Doctor
Betahistine dihydrochloride definitely works, but it is unavailable in the USA.
So we can avoid epley by being careful and taking meds?
Does it have side effects? Can it be used for ppl like me who cant ttolerate epley@@stazym69
Haah...I did vertical head movement..that was the culprit..
dang so there's nothing you can do to stop it coming back.
You can avoid the 3 things I mention and make sure your vitamin D levels are normal. But otherwise, you're correct, there's not much you can do.
I have MS and not allowed to do epley. Will bppv eventually go with proper hydration vitamins rest and watching movements plus meds? I get seizures cant do any epley. Got an inner infection snce a month and was gven wrong antibiotics snce bppv never went but i do sleep upright but still get floating random attacks. I dont thnk its purely bppv.
I have it now it is horrible. Debilitating.
Here's another thing to avoid - DON'T DO SIT UPS - this is extremely annoying when you've purchased a Roman Chair just to do that. Stick to planks instead.