Although most people with BPPV can be treated with the Epley maneuver or a home treatment device. About 5-12% of people cannot be treated. There are several reasons which should be carefully considered.
1) You do not have BPPV. There are many kinds of vertigo and only BPPV will respond to the Epley maneuver. You should always get a proper diagnosis from a physician qualified to diagnose BPPV. Several serious conditions can cause vertigo as part of their symptom complex and these other conditions should be ruled out.
2) You have BPPV but are doing the maneuver incorrectly. This is actually the most common reason for treatment failure in people with BPPV. This may be because you are treating the wrong side or may be because you are performing the maneuver too quickly, with the wrong angles or in the wrong order. The maneuver is only effective when performed totally correctly. A BPPV treatment device to assist in the correct performance of the maneuver is available and will visually guide a person through the maneuver.
3) You may have a resistant form of BPPV. This may be due to the fact that the otoconia, or ear crystals, get stuck in the balance canal or that they get glued to the end of the canal. It is not clear which is true but it seems that some people don’t respond whatever they do.
4) You may have BPPV in both ears. Due to the nature of BPPV if you have it in one ear it is certainly possible to get it in both ears. Typically this will present with symptoms on both sides. A physician can tell you if this is the case. The Epley maneuver will still work but you will have to do it on both sides. People often ask if doing one side and then the other will reverse the benefit of the first maneuver. It is not clear that this is true however, we always tell people to treat one side one week then the other side the next week.
With these issues in mind it doesn’t hurt to perform an Epley maneuver in a repeated fashion, it might help but this cannot be guaranteed. The only caution is that if you have symptoms which do not seem related to BPPV such as weakness or confusion you should seek medical attention.
admin says:
Sadly the best thing to do is to seek medical attention to get a proper diagnosis. Once you know if you have BPPV or not then it is possible to pursue effective treatment at home. The initial episode you describe “two weeks of spinning dizziness” sounds like labyrinthitis. Sometimes this type of infection can cause subsequent BPPV episodes. You describe short episodes of spinning in a particular position. This certainly sounds like BPPV but should be diagnosed by your doctor. Following those episodes of BPPV you describe an off balance feeling. This can sometimes be caused by re-adaptation to a successful treatment maneuver – what I mean is that you may have become used to the crystals which cause BPPV – now that you have moved them out (the spinning is gone) you feel sea-sick. Usually this resolves on its own. Again if you are having strange symptoms you should seek the advice of your own physician.
22nd March 2011 at 7:32 pm
manda says:
I have been diagnosed with BPPV 6 months ago. I woke up spinning violently and went to ER immediately. They had no idea what was wrong and sent me home. I lived off of Gravol (which really didnt help) and had to take almost 2 weeks off from work. Once back to work I still had dizzness when I moved my head but could function. After 2 months I was directed to a Physio who preformed the epley maneuver and I was 100% before within 24 hours. It’s been 6 months since I have been dizzy and 5 days ago I woke up spinning.. again. It was the same feeling I remember. This time tho I noticed it was the other ear. When i leaned towards the left I would spin but not violently. The room was moving a lot slower then I had remembered, Spinning none the less and no rapid eye movement. Since now I live in an area where I would have to fly out to seek medical attention I have been tring this maneuver on my own. But it’s not working. Im worried maybe something else is going on. I find now after a week the spinning has stopped and now im very off balance. Im having troble walking and head movements do not cuz me to spin but rather feel extreamly sea sick. I have started doing the log roll in the morning and once at night. Any advice?
21st February 2011 at 11:08 am