Anyone been diagnosed with BPPV?
Discussion
A few weeks ago my wife was having dizzy spells when going to lie down and when getting up from doing so. So she saw our GP and he diagnosed BPPV. Googling this seems he was correct: she has been showing all the symptoms. The GP said that it may disappear, but if not she must go back to him and he'll perform the Epley Manoeuvre which is a recognised cure. She will be seeing him again soon. So, any PHers had experience BPPV and the Epley Manoeuvre? Did it work?
Thanks.
R
Thanks.
R
This diagnosis is very age dependent.
Anyone over 40 needs to be referred to an ENT surgeon for a full diagnostic workup.
I wouldn't mess about at under 40 either tbh.
Lots of causes of BPPV (benign paroxysmal positional vertigo) other than calcification within the vestibular canals.
IMHO this is not a diagnosis to be tinkered with by a GP, particularly in an older individual.
100% would not be letting the GP chuck your wife around in an attempt to perform the hardly ever used or successful Epley manoeuvre.
Very easy to cause a lot of damage doing that in an older individual.
Go private to an ENT surgeon.
Anyone over 40 needs to be referred to an ENT surgeon for a full diagnostic workup.
I wouldn't mess about at under 40 either tbh.
Lots of causes of BPPV (benign paroxysmal positional vertigo) other than calcification within the vestibular canals.
IMHO this is not a diagnosis to be tinkered with by a GP, particularly in an older individual.
100% would not be letting the GP chuck your wife around in an attempt to perform the hardly ever used or successful Epley manoeuvre.
Very easy to cause a lot of damage doing that in an older individual.
Go private to an ENT surgeon.
I had viral labrynthitis a few years ago (and I still can't spell it!) - it cleared up on its own but the first few days were horrible with the room constantly spinning (a little bit like seasickness with nausea). The doctor did try the BPPV manoeuvre on me which didn't work and luckily the Lab....cleared up over time.
I had a sudden onset of vertigo in the swimming pool. Very weird. Swimming front crawl and suddenly felt as if I was turning like a corkscrew. Got to the end of the lane and took me a few minutes before I had the balance to get out of the pool and to the toilet to throw up. Had to abandon the car and get OH to drive me home. GP thought it was a viral vestibulitis but it settled as suddenly as it started so I realised it was more likely BPPV
I looked up the Epley manoeuvre and have managed to abort a couple of episodes by a DIY version hanging my head over the edge of the bed.
Essentially you have a crystal stuck under the sensor in one of the semicircular canals in the inner ear. The Epley manoeuvre is a sequence of movements matching the planes of each of the canals aiming to dislodge the crystal.
It's one of the coolest tricks you can perform as a medic as it's a very rare example of laying on hands and giving instant relief.
I looked up the Epley manoeuvre and have managed to abort a couple of episodes by a DIY version hanging my head over the edge of the bed.
Essentially you have a crystal stuck under the sensor in one of the semicircular canals in the inner ear. The Epley manoeuvre is a sequence of movements matching the planes of each of the canals aiming to dislodge the crystal.
It's one of the coolest tricks you can perform as a medic as it's a very rare example of laying on hands and giving instant relief.
If that is the diagnosis then desensitisation exercises are very helpful.
Head still, rotate eyes 10x clockwise then 10x anti-clockwise.
Same again but move head in the same direction as well.
Same again but swing your arms around with your head as well.
Start slow.
Have something to fall onto that's nice and soft and plenty of room available.
Maybe have your other half with you to catch you or the vomit (don't do these exercises after a large meal).
Only do these exercises after the diagnosis has been confirmed to be BPPV following investigation by an expert.
There are many causes of vertigo.
Few to chew on, off the top of my head (so to speak);
Viral
Bacterial
Fungal
Vascular - aneurysm, AVM, septic embolus, paradoxical embolus, TIA, arterial infarct
Neurological - MS, vascular neurodegeneration, brain stem degeneration, space occupying lesion (vestibular schwannoma, benign or malignant tumour, acute or chronic haematoma)
Trauma - head injury
etc.
Head still, rotate eyes 10x clockwise then 10x anti-clockwise.
Same again but move head in the same direction as well.
Same again but swing your arms around with your head as well.
Start slow.
Have something to fall onto that's nice and soft and plenty of room available.
Maybe have your other half with you to catch you or the vomit (don't do these exercises after a large meal).
Only do these exercises after the diagnosis has been confirmed to be BPPV following investigation by an expert.
There are many causes of vertigo.
Few to chew on, off the top of my head (so to speak);
Viral
Bacterial
Fungal
Vascular - aneurysm, AVM, septic embolus, paradoxical embolus, TIA, arterial infarct
Neurological - MS, vascular neurodegeneration, brain stem degeneration, space occupying lesion (vestibular schwannoma, benign or malignant tumour, acute or chronic haematoma)
Trauma - head injury
etc.
It's bloody miserable.
The first time I experienced it I was at home, watching rugby. I started to feel hot and sweaty, followed by feeling dizzy and sick.
I thought at the time it was a reaction to watching Quins put three tries on Wasps in a very short time, but soon realised that I was quite ill. I called my sister, who lives nearby, she came round and immediately called an ambulance.
The paramedics were excellent, having first suspected that I was having a stroke, then subsequently settling on BPPV. They gave me an injection to stop the sickness, by which point I wouldn't have cared if they were injecting me with Novichok, I was feeling that wretched.
In the end I spent three days in bed, couldn't face eating anything, but drinking lots of water. A week or so later I went to see my GP, who confirmed the diagnosis, and I was feeling much better by this time.
I've had one (milder) episode since (the original was in February 2021) in 2024, I went to the local "Urgent Treatment Centre", the GP did the Epley manoeuvre, which made me feel very unwell, and I've been fine since. I start to worry if I find the room spinning slightly when I lay down to go to sleep, but otherwise I feel ok.
It's unsettling to think that it can suddenly come out of the blue, and it's thoroughly unpleasant for the sufferer or anybody in their immediate vicinity if it does occur. We're complex beings, occasionally something goes wrong,
The first time I experienced it I was at home, watching rugby. I started to feel hot and sweaty, followed by feeling dizzy and sick.
I thought at the time it was a reaction to watching Quins put three tries on Wasps in a very short time, but soon realised that I was quite ill. I called my sister, who lives nearby, she came round and immediately called an ambulance.
The paramedics were excellent, having first suspected that I was having a stroke, then subsequently settling on BPPV. They gave me an injection to stop the sickness, by which point I wouldn't have cared if they were injecting me with Novichok, I was feeling that wretched.
In the end I spent three days in bed, couldn't face eating anything, but drinking lots of water. A week or so later I went to see my GP, who confirmed the diagnosis, and I was feeling much better by this time.
I've had one (milder) episode since (the original was in February 2021) in 2024, I went to the local "Urgent Treatment Centre", the GP did the Epley manoeuvre, which made me feel very unwell, and I've been fine since. I start to worry if I find the room spinning slightly when I lay down to go to sleep, but otherwise I feel ok.
It's unsettling to think that it can suddenly come out of the blue, and it's thoroughly unpleasant for the sufferer or anybody in their immediate vicinity if it does occur. We're complex beings, occasionally something goes wrong,
Quite timely seeing this topic as it's possibly something I'm experiencing this week. Started feeling dizzy and unbalanced at work on Monday, but not too bad. Woke up Tuesday with worse dizziness, spinning sensation, as well as feeling sick and having diarrhea.
It's confusing if it's BPPV or vestibular neuritis (inflammation of the vestibular nerve carrying balance signals from the ear which can be caused by another viral infection eg flu, cold, gastrointestinal etc). I know BPPV can cause nausea and sickness, which is why I thought it was the possible cause given the dizziness started first, however half my team has also gone down sick this week, but without the vertigo symptoms, making me think it's a viral thing causing vestibular neuritis.
Anyway, the sickness and diarrhea only lasted the Tuesday but the vertigo symptoms are still here. Will see if its subsided on its own by the weekend, or get seen, but I'm not sure there's much can be done about it.
When I walk, it's like I've drunk 10 pints but without the incoherence or fun of doing that.
It's confusing if it's BPPV or vestibular neuritis (inflammation of the vestibular nerve carrying balance signals from the ear which can be caused by another viral infection eg flu, cold, gastrointestinal etc). I know BPPV can cause nausea and sickness, which is why I thought it was the possible cause given the dizziness started first, however half my team has also gone down sick this week, but without the vertigo symptoms, making me think it's a viral thing causing vestibular neuritis.
Anyway, the sickness and diarrhea only lasted the Tuesday but the vertigo symptoms are still here. Will see if its subsided on its own by the weekend, or get seen, but I'm not sure there's much can be done about it.
When I walk, it's like I've drunk 10 pints but without the incoherence or fun of doing that.
OP here with an update.
Since my original post, my wife's incidence of BPPV had declined, but it still occurs sometimes when she gets out of or into bed. She seems OK otherwise. Then recently she had one morning when she got up and was exceptionally dizzy. She already had a follow up appointment with her GP the next day so we reported progress etc at that time. Her GP decided to use the Dix-Hallpike method to determine which ear was the problem, and then he performed the Epley manoeuvre. GP advised me to do the EP with her at home three times a day until things improved.
Fortunately (for her and me!), the BPPV seems to have been cured by the GP performing the EP. She has had no reoccurrence. Here's hoping this continues for her.
R.
Since my original post, my wife's incidence of BPPV had declined, but it still occurs sometimes when she gets out of or into bed. She seems OK otherwise. Then recently she had one morning when she got up and was exceptionally dizzy. She already had a follow up appointment with her GP the next day so we reported progress etc at that time. Her GP decided to use the Dix-Hallpike method to determine which ear was the problem, and then he performed the Epley manoeuvre. GP advised me to do the EP with her at home three times a day until things improved.
Fortunately (for her and me!), the BPPV seems to have been cured by the GP performing the EP. She has had no reoccurrence. Here's hoping this continues for her.
R.
OIC said:
There are many causes of vertigo.
Few to chew on, off the top of my head (so to speak);
Viral
Bacterial
Fungal
Vascular - aneurysm, AVM, septic embolus, paradoxical embolus, TIA, arterial infarct
Neurological - MS, vascular neurodegeneration, brain stem degeneration, space occupying lesion (vestibular schwannoma, benign or malignant tumour, acute or chronic haematoma)
Trauma - head injury
etc.
That's mildly terrifying Few to chew on, off the top of my head (so to speak);
Viral
Bacterial
Fungal
Vascular - aneurysm, AVM, septic embolus, paradoxical embolus, TIA, arterial infarct
Neurological - MS, vascular neurodegeneration, brain stem degeneration, space occupying lesion (vestibular schwannoma, benign or malignant tumour, acute or chronic haematoma)
Trauma - head injury
etc.
I was diagnosed with it back in 2013 (but had an episode in 2011 for which I didn't go to the doctor).
Had a few episodes over the years, then 'a big one' in winter 2019 (had to get a lift home from work in the middle of the day.l).
After that I had 6 completely clear years before having a dose of it last September.
I'm working on the basis that since i'm not dead 15 years later, the diagnosis was right and it's not any of the above options
My method is to sit upright and focus on the far distance (_far_ as in trees on the other side of a field etc, not just the other side of the room) until the nystagmus passes; after that, force myself to try and behave/move normally as far as possible in order to desensitise/get my brain used to that bloomin' otolith floating around in there.
Its pretty unpleasant, but If I were to just sit still with my eyes closed it would take several days or more get better.
I'll try and remember those specific desensitisation techniques for next time.
Edited by chris1roll on Thursday 10th September 17:11
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