![]() While this experience lasts only a few seconds, it serves as a strong indication that the repositioning maneuver has been successful. As a result, patients may feel as if they are suddenly propelled out of their chairs, leading to instinctive reactions such as screaming, arm waving, and forceful pitching forward or backward. This timeframe is generally sufficient for the procedure to be effective.ĭuring the final position of the Canalith Repositioning, it is not uncommon for patients to experience what is known as a “Tumarkin’s Otolith Crisis.” This sensation, often referred to as “totally freaking out” in the practitioner’s office, occurs when the otoconial debris, upon exiting the posterior canal, directly stimulates the utricle. The key is to ensure that any moving otoconial debris has ceased its motion, which is typically accomplished within approximately one minute in each position. However, based on personal observations from an experienced practitioner who has performed thousands of Canalith Repositioning Procedures (CRP) over the past two decades, it appears that the maneuver may be more complex than necessary.ĭespite this, the success rate of the procedure has consistently exceeded 90% in a single session.Ĭontrary to some approaches, no vibratory devices are used during the procedure, and precise timing of each head movement is not a major concern. ![]() If they continue to be dizzy for over a week of attempting this, then I advise them to try the classical version.The Epley Maneuver, initially described by John Epley in 1992, has been widely used for the treatment of Benign Paroxysmal Positional Vertigo (BPPV). Often times, my patients report they no longer are dizzy after doing the Epley maneuver three times in a row, several times a day, for a couple of days. So, I advise people to do the Epley maneuver several times in a row, until they are no longer symptomatic. The fact that BPPV is caused by debris slowing the flow of fluid in one canal, I figured, once the debris is back in the sac, you should be asymptomatic. Visit my YouTube channel you would like to see the Epley maneuver and/or my modified version. If not, or if your condition worsens in any way, see your health care provider.īeing a supporter of movement, I modified the Epley maneuver, and found it to be successful in most cases. You should notice an improvement within a day or two. Perform the Epley Maneuver on that side up to three times, three times a day. Repeat the side that makes you feel the dizziest. If this did not make you very dizzy, repeat on the other side, this time first turning your head to the left and ending with your head turned to the right. Then look straight ahead and see how you feel. Hold this position until you are no longer dizzy. Keep your head turned to the left with your chin tucked in. Take your legs off the table and use your arms to push yourself up. Hold for 1-2 minutes (I say just hold until you are no longer dizzy)Īgain, hold this position until you are no longer dizzy. If you are doing the correct side (affected ear down), you will experience dizziness, as your eyes will flicker back and forth (nystagmus). Keep your head turned to the right as you lay back. Then lay back with your head over the bed/table: ![]() To perform this maneuver, you need a flat surface (like your bed or floor), and a pillow to lay on, so that when you lay down your head will extend back. To see how to do the Epley Maneuver, watch the video or see the description of the Epley Maneuver below: To encourage the debris out of the canal and into the sac, Dr. It may take a while for the debris to work its way out of the canal naturally. What does this mean? The symptoms are gone? It should take a long time before the material finds its way into the canal again. If this debris dumps into the big sac of the inner ear, it is asymptomatic as they are no longer in the way of the pressure sensitive canal that tells us if we are moving in a direction. The good news is this blockage can work its way out of the canal, and dump into the big sac of the inner ear. Hence, you experience vertigo, which is very nauseating. Since you are not spinning, when your brain reflexively move your eyes like it should if you are spinning, it makes the world look like it is spinning around you. With this aberrant input, your poor brain incorrectly concludes that you must be spinning, and moves the eyes accordingly. If one ear is blocked, it cannot sense this motion, so your brain is told by one ear you are turning, and the other ear you are not. ![]() In healthy inner ears, without blockage, when you turn your head to the right, both ears agree that you are turning your head right. THE EPLEY MANEUVER TO TREAT BPPV DIZZINESSīPPV, Benign paroxysmal positional vertigo, is caused by excessive debris in one of the canals of the inner ear.
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