Hello everyone,
I am a little confused about what I am feeling right now. I am about 99% certain I had BPPV last July, and I did the epely maneuver which stopped the vertigo when I put my head back. It seemed to be classic BPPV because there was always a 5-10sec pause before a brief vertigo episode occurred. After doing the epely twice I was cured of the vertigo.
So now to my question, why would I still get residual symptoms when in the head back 45 degree position? I feel like I did just prior to the vertigo but the vertigo never happens. I am doing all kinds of VRT exercises and have a weight routine at the gym where I incorporate balance exercises with weights (things like doing curls while standing on one leg, and lots of medcine ball twisting exercises etc) Afterwards I feel a little woozy, almost like I am going to get dizzy again but never do. If I moved the crystals back into position with the epely, what is this other junk about, what is causing a decompensation if everything is in place? Do the crystals move back but not in the original position which is what I am compensating for? And why do I have days when I have very little symptoms and days like today when I am feeling really heady.
When I had labs four years ago, I could understand how I had to compensate for a loss of function of my right ear by 37% and now wonder if I am continuing to compensate for that and these symptoms are from the labs and not the actual BPPV.
This is kind of a confusing post, sorry about that but would love to know if anyone has any ideas about this.
thanks for any information anyone has on this.

Hello everyone,
I am a little confused about what I am feeling right now. I am about 99% certain I had BPPV last July, and I did the epely maneuver which stopped the vertigo when I put my head back. It seemed to be classic BPPV because there was always a 5-10sec pause before a brief vertigo episode occurred. After doing the epely twice I was cured of the vertigo.
So now to my question, why would I still get residual symptoms when in the head back 45 degree position? I feel like I did just prior to the vertigo but the vertigo never happens. I am doing all kinds of VRT exercises and have a weight routine at the gym where I incorporate balance exercises with weights (things like doing curls while standing on one leg, and lots of medcine ball twisting exercises etc) Afterwards I feel a little woozy, almost like I am going to get dizzy again but never do. If I moved the crystals back into position with the epely, what is this other junk about, what is causing a decompensation if everything is in place? Do the crystals move back but not in the original position which is what I am compensating for? And why do I have days when I have very little symptoms and days like today when I am feeling really heady.
When I had labs four years ago, I could understand how I had to compensate for a loss of function of my right ear by 37% and now wonder if I am continuing to compensate for that and these symptoms are from the labs and not the actual BPPV.
This is kind of a confusing post, sorry about that but would love to know if anyone has any ideas about this.
thanks for any information anyone has on this.

Well it could be:

Takes a while for the "rocks" to dissolve or stick---depending on which theory you buy into----usually three complete sets(three maneuvers for each set) of MEP's/Epley's are required---before---you can say---that---rocks are out----however does not mean---they will stay out---depends on---what you do afterwords(movements)----during my 13/14 months had to do MEP's numerous times---because---I made some type of movement/maneuver---that---put them back into the canal---before they(rocks) completely dissolved/stuck----it is a two step process:

1st Step:

ear rocks must get out of canal---dissolve/stick---whatever---compensation(full) will not take place---until their(rocks) are out/gone---no matter how many VRT's/exercises you do---the equilibrium center of the brain---can not compensate---for a constantly changing and moving "physical mass"(which is what the rock(s) are)---because----with the rocks in there---and moving---when you assume certain positions(remember it is not the position---it is the "positioning" that causes the problem)---the brain must constantly calculate/recalculate at a nano-second rate---for the slightest positioning of your head---it does not have the processing power to do that---comensation can/will not take place until the mass(rocks) are out and stay out!!

2nd Step:

Once the rocks are out---then compensation can begin---there is usually some type of vestibular balance deficit---either permanent or temp---i.e., neuron's that were destroyed---can regenerate---with time---but it take time---usually a lot of time---to retrain---the brain's equilibrium center---and for it to do the myriad of calculations necessary---for things(balance/movements) to get back to auto----after all you have been developing those movement equations---since you first moved as an infant and locking them into "movement templates",i.e., neuron clusters, i.e., long term memory----however none of that can take place---until the rocks are out and stay out!!

And---because---all of that rolling around---that the rocks do---weakens--the inner ear structures---and the older you are----the more likely---in time---that the rocks will---slip back in---and you start the process over again---which is why I added the MEP---to my daily routine--at least twice a week...

Until you get the 1st Step done---and it sticks---no amount of VRT's/exercises---will help---in fact---prob hurt----It's as simple as that---for BPPV!

P.s. See the info archive(sticky) post at top of the board---and "Chronic Dizziness"---it is explained there.

:cool:

Wow. I'm glad I read this post - there's a lot of important and helpful information here!
Why don't the bloomin' Drs seem to know this much/tell us this? *sigh*
Well I guess maybe a neuro-oto does but I haven't managed to get to see one yet as I really hate travelling right now.

My actual vertigo has got a lot better and the violent dizzy attacks have been happening less and less and when they do occur its not as severe at all. I too though have the feelings of imbalance/whooziness/dizziness as if the swooping/violent walking-on-a-ferry-in-rough-seas-like imbalance is about to happen again.
(Not to mention the brain-fog, feeling on drugs and HORRIBLE disorientation).

I am going to start doing the Modified Epley Manoeuvre! Do you know my ENT "assured" me in an argument I had with her that you only need to do the Epley once for it to be effective? Grrr (yeah sometimes this may be the case!)



"Until you get the 1st Step done---and it sticks---no amount of VRT's/exercises---will help---in fact---prob hurt----"

Eeek! Well how do we knoooow if the rocks are out and we'll start to compensate/can embark on serious VRT.
How do we know if we are doing more damage? :confused:



Thanks for great advice.

Hope you're still feeling good Subs and glad to hear you're feeling quite good some of the time Firechick and hope you feel a LOT better soon!!

Katkin xxx

Hi Katkin

My take is:

....."we knoooow if the rocks are out".....

Well----for BPPV--after "Three Sets of the MEP" in my case----with no vertigo/feeling of vertigo.......then start VRT's---but don't over do it---since---your not sure---if they are permanently gone----at first sign of---vertigo/feeling of vertigo----test possibility---that they sliped back---with MEP's---if on any maneuver of the MEP set(It will usually occur on the first)---vertigo/feeling of vertigo---their prob back---then---must do----at least three MEP sets---without any feeling/vertigo spaced out over 24 hour period....then back to VRT's--but go easy again----if after---a period of time(months) of VRT's---with no sign of vertigo/feeling of vertigo----pick up the VRT pace---but---do not over do it----continue to pick up pace----but with the understanding---it takes a considerable amount of time(could be years)---for the rocks to stick/dissolve---if you buy into that theory

---Once their(rocks) out---for the compensation period-----remember---when locking in "Long Term Memory" i.e., establishing/reestablishing the connections between the Neuron's that make up the Neuron Cluster's--i.e., preplanned movement templates---it requires perhaps as long as 8 to 10 hours of---for the transfer--from "Short Term" memory to Long Term Memory, i.e., the calcium channels on the Neuron Cell(s) must open---to allow for the synapse to active/fire---reinforce/establish the cluster---which means repetitive VRT exercise sets---space out---within---the transfer period.......no reasonable way to accelerate the process---that I know of---given the physics of what your basically dealing with---maybe a pill one day....whatever......if you understand it you can lick/beat it---by using that understanding to out smart it and overcome it---what happened

---the body(as a system)can undo/correct/compensate---understand what's taking place---and---use that to---Kick it's butt!!!

Yep---still at 100%---been almost 24 months(knock on wood)

:cool:

Thanks Subs30, that is the best explanation I have had yet. As for your second post to Katkin, are you saying you should be doing the VRT within an 8-10 hour period to establish the link from short term to long term memory? I often wonder after doing some exercises if I have overdone things but typically feel better after about 12 hours once things have settled down. I am pretty sure the rocks are out of my canals as I have had 0 vertigo for about 7 months but get feelings on and off that it is impending, but it never materializes. I do the MEP when I get those feelings. I think I will take your advice and continue to do them even when I am feeling well just to keep things at bay.
Thanks again, hearing you are at 100% without any recurrences for 24 months is inspirational!

Oh that is SO BRILLIANT Subs!!!!! I'm absolutely over the moon for you to hear that!!!!! :D
Coooool, 24 months of feeling 100% - Sounds gorgeous!

Thank you so much for all the advice! Really helpful and more informative about BPPV than a lot of things I've read! Well anything I've read or been told really!!!

I think I understood most of that 2nd post but I didn't quite understand that 8-10 hours bit either.

Thank you and look forward to reading your reply! :D

Katkin xxx

Hi

...."VRT within an 8-10 hour period to establish the link from short term to long term memory?"......

Not exactly----not sure---what VRT exercises---you have been given---but---Univ of Penn---will have you do a certain set---with no variations---from the specific exercise(s)---for about a week---the hope is---I suspect---that if you do those same exercises---repetitiously & let say 4 times a day---through out the day---each day---for a week----that the period of time it takes to move from Short Term to Long Term---will will be covered----the 8 to 10 hours---varies on a person to person basis and is kind of a theoretical norm---I don't think they(Neuro's) know with a high degree of accuracy---my guess--is---it is some where around that period of time---some argue---if during your waking hours---what you do(exercises) are the same and repetitively done---most of the transfer---occurs during the sleep cycle---but whatever....the evidence...is pretty clear---that practice makes perfect---which is why you see the Pro's in anything---out there---practicing their moves/maneuvers---what ever the sport/game/movement----the key is to have the brain do the calculation---then fine tune it---until---there is no more---reasonable--gain---to be had----then lock it into memory---so that when you attempt it---it is almost an unconscious action--and

--since ---movements---we all make---are memory driven,i.e., what I call "preplanned movement templates" and they(Doc's) call long term memory(also another name for it, declairative..whatever)

---it really is only the last few nano seconds of your actual movement---that the brain needs to calculate and adjust your motion for force/speed, etc....since 99.999% is coming from the Preplanned movement template"----unless of course---you never made that type of movement---routinely---before---such as turning cartwheels, etc..or this junk screwed up the existing preplanned movement template

Your brain is capable of thinking movements in real time(i.e., I'll touch.....)---that "touch" movement has to many possible movement variations---for the brain---to run the necessary calculations that would direct the various systems actions the complete movement---in real time------just does not have the processing power---capacity---to dedicate to that---with everything else---it is required to do

---which is---why---when this junk screws up the preplanned movement template---repertoire---that you had---cemented away---in those neuron clusters----called long term memory---that took you a life time to assemble--and calculate---you get "Brain Fog"----since then/now---the brain must reestablish---whatever was screwed up---and still do real time calculations on your movements---and---that takes away from it's other tasks "Big Time"......like moderating anxiety, reading, etc.....

It truly is a piece of work!!!!!!

:cool:

Hi Katkin

My take is:

....."we knoooow if the rocks are out".....

Well----for BPPV--after "Three Sets of the MEP" in my case----with no vertigo/feeling of vertigo.......then start VRT's---but don't over do it---since---your not sure---if they are permanently gone----at first sign of---vertigo/feeling of vertigo----test possibility---that they sliped back---with MEP's---if on any maneuver of the MEP set(It will usually occur on the first)---vertigo/feeling of vertigo---their prob back---then---must do----at least three MEP sets---without any feeling/vertigo spaced out over 24 hour period....then back to VRT's--but go easy again----if after---a period of time(months) of VRT's---with no sign of vertigo/feeling of vertigo----pick up the VRT pace---but---do not over do it----continue to pick up pace----but with the understanding---it takes a considerable amount of time(could be years)---for the rocks to stick/dissolve---if you buy into that theory

---Once their(rocks) out---for the compensation period-----remember---when locking in "Long Term Memory" i.e., establishing/reestablishing the connections between the Neuron's that make up the Neuron Cluster's--i.e., preplanned movement templates---it requires perhaps as long as 8 to 10 hours of---for the transfer--from "Short Term" memory to Long Term Memory, i.e., the calcium channels on the Neuron Cell(s) must open---to allow for the synapse to active/fire---reinforce/establish the cluster---which means repetitive VRT exercise sets---space out---within---the transfer period.......no reasonable way to accelerate the process---that I know of---given the physics of what your basically dealing with---maybe a pill one day....whatever......if you understand it you can lick/beat it---by using that understanding to out smart it and overcome it---what happened

---the body(as a system)can undo/correct/compensate---understand what's taking place---and---use that to---Kick it's butt!!!

Yep---still at 100%---been almost 24 months(knock on wood)

:cool:
i have had vertigo for a week now. the last time i had this was 9 years ago and it disappeared in a week's time. i have been doing an exercise sitting on the side of my bed and laying to the left, straight up, and then to the right. i think it is called the epley procedure not knowing which ear is affected. i know that the only dizziness if have felt as when i lay to the right so is my problem right ear side you would say? i have been doing this every day and the dizziness is almost gone. i don't know what "mep" means and then "vrt". are these exercises too? can you explain as you probably have to many others just one more time?

You're more than likely doing the Brandt-Daroff exercises. I think they're a waste of time and don't do anything to move the otoliths.

The MEP is the Modified Epley Procedure/Maneuver.

There's also the Semont Maneuver.....the head is held in a specific position, then one lays quickly to the affected ear side, then to the other side (after specified time)....it's not done repeatedly as the B-D exercises.

There's also the GANS which might help.

The key is to know which ear and what maneuver will help. If the otoliths are moving through the canal, then the Epley or MEP would help. If they are stuck to the cupulla....then the Semont or the GANS could help.

I've had BPPV for 39 years. It comes and goes. It started in the right ear and then eventually the left one (I think a viral infection started that one). A fall started the right ear one. Both ears act differently in attacks. There was a period of time when both were in attack....WooHoo...life WAS like a merry-go-round for sure!

VRT means vestibular rehabilitation treatment/training.

What side is your BPV?

There's a book called "BPPV: What You Need to Know" by P.J. Haybach. It's available online through the Vestibular Disorders Association (VEDA). I bought it when I was at the worst and it has awesome info.

Are you seeing a doctor for possible treatment?

I think if you know the side it's on, you'd probably be able to do the treatment yourself....as well, the sooner you do an effective treatment, the quicker the attack will be over.

Hope this attack is short-lived for you.

quincy

Hi Babag

....."so is my problem right ear side you would say?"......

Yep---could be otherwise--- but in about 60%+ of the cases---they say---it is the side that you get dizzy on/from when laying down----sounds like your doing: (from Northwestern Univ web site)

HOME TREATMENT OF BPPV:


..."The Brandt-Daroff Exercises are a method of treating BPPV, usually used when the office treatment fails. They succeed in 95% of cases but are more arduous than the office treatments. These exercises may take longer than the other maneuvers -- the response rate at one week is about 25% (Radke et al, 1999). These exercises are performed in three sets per day for two weeks. In each set, one performs the maneuver as shown five times."...

....." "mep" means "....

As Quincy says Modified Epley Procedure---if you go to the "info archive" post at the top of this board---scroll down to:

...."Self-treatment of BPPV - Modified Epley Procedure (MEP) - A Radtke et al"...

You can down load the MEP instructions and video for the procedure---with the info posted....also covers VRT, etc....worth taking a look at.....

:cool:

Hi Babag

....."so is my problem right ear side you would say?"......

Yep---could be otherwise--- but in about 60%+ of the cases---they say---it is the side that you get dizzy on/from when laying down----sounds like your doing: (from Northwestern Univ web site)

HOME TREATMENT OF BPPV:


..."The Brandt-Daroff Exercises are a method of treating BPPV, usually used when the office treatment fails. They succeed in 95% of cases but are more arduous than the office treatments. These exercises may take longer than the other maneuvers -- the response rate at one week is about 25% (Radke et al, 1999). These exercises are performed in three sets per day for two weeks. In each set, one performs the maneuver as shown five times."...

....." "mep" means "....

As Quincy says Modified Epley Procedure---if you go to the "info archive" post at the top of this board---scroll down to:

...."Self-treatment of BPPV - Modified Epley Procedure (MEP) - A Radtke et al"...

You can down load the MEP instructions and video for the procedure---with the info posted....also covers VRT, etc....worth taking a look at.....

:cool:
thanks so much. i have been doing the brandt-daroff for almost a week now. my symptoms are down, possibly leaving me at 95% cure. i will keep doing them for awhile. i had this 9 years ago and it passed with no exercises in a week's time. i remember that my dr. did some manuvering of my head in his office. perhaps he put the cure to it alone. i have printed off all of these exercises. my doctor didn't see me this time and i will surely go back to him if it returns.