First - let me say thank you for all the valuable information you've provided on these boards ... as a BPPV sufferer, it has really helped me alot.

I had a couple of questions for you and I've read many of the "sticky" notes and talked with two PTs about my situation, but I'm hoping you can give me some info in plain language ...

Yesterday, I had my 5th Epley since January. And, this time, my PT said it was in my horizontal canal. When I read the sticky, they don't talk about a horizontal canal - but a lateral canal .... I'm assuming this is the same???

Also, I had finally gotten a sense of peace about all this crap because for my 4th Epley, I was able to do the MEP to successfully treat it. I tried to treat myself this time, and since it was in the horizontal canal, it didn't do any good.

When I went in for treatment , the PT had me do the "log roll" along with a bunch of other things and then finally ended up with the Epley. Unfortunately, when I'm in the middle of going thru all that with the PT, I am not really able to pay attention to what all the various movements are ... but my question is this: Do you know of a way to deal with the horizontal canal at home? Log roll followed by Epley?? I'd just lilke to better understand what's going on and have the knowledge that I could treat this myself if necessary - i.e. on vacation, out of town, etc. (maybe that's not a good idea, I don't know?)

Last - Any stats, studies or info you can provide on people who have to have multiple Epleys??? I'm just curious as to why this keeps happening .... at one point my dr. thought I possibly also had VN - so I'm thinking maybe that's it - but who knows. I'm also really curious if this is the same crystal floating around and never really getting addressed; new crystals forming; or crystals continually moving into the canal???? I'm guessing there's really no way to know, but I thought if anyone would know - you would!!

Thanks for reading all of this!

Hi Ssdizzy

Went back and read ur other post(Jun I think) what type of Doc/PT are u seeing, what was Doc's Dx and how experienced are they(both) in this medical area?? Ur impression(s)?? Is the reason ur having the Epley done---repeatable---because of vertigo attacks??

Be back to u---want to look up a couple of research papers Scott had ID'd.

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Thanks Subs -

The dr I've been seeing is a neurotologist. My first Epley was done by a PT at the neurotologists office in Jan. Then in early May, I began working with a different PT who specializes in VRT/balance disorders (her office is much closer to my home than the dr). She did two of the Epleys. My latest Epley was back at the neurotologists office and was originally supposed to be using the Epley chair which they have recently added to their practice. However, the day of my appt., the chair was malfunctioning so they had to just do manual repositioning stuff. (I was really hoping that the chair might make a difference.)

So, i guess to answer your question, it seems that the people I have been working with are very knowledgable since they specialize in this stuff .... but I can't seem to get any answer on why this keeps happening.

The reason I have had to keep repeating the Epley is because I end up having the spinning vertigo resulting from specific head movements. I have dealt with the general disequilibrium in between Epleys ... but the VRTs made a HUGE difference for that. So, now when the crystals move now - it is very obvious to me that something shifted and then after the Epley, that sensation goes away. So, I really believe the repositioning manuevers are working ... but just wish I didn't have to keep going thru all this!

I look forward to seeing what info you come up with. Thanks in advance for taking the time to respond.

I'm not Subs obviously but...

but I can't seem to get any answer on why this keeps happening.

That's exactly the problem I'm having. The Epley helps but the vertigo keeps coming back and nobody can explain why. If you find out anything, I'd be really interested.

....The dr is a neurotologist.....Epley was done by a PT at the neurotologists office......PT who specializes in VRT/balance disorders....She did two of the Epleys......latest Epley was back at the neurotologists office supposed to be using the Epley chair.....chair was malfunctioning so...just do manual repositioning stuff.....seems that the people I have been working with are very knowledgable since they specialize in this stuff ....

The reason I have had to keep repeating the Epley is because I end up having the spinning vertigo resulting from specific head movements.....VRTs made a HUGE difference for that....then after the Epley, that sensation goes away. ......

Hi Ssdizzy

It sounds like ur in excellent hands---think I would try for the Epley Chair---when they get it working(hope that is not to far away) think(as u do) that could make a difference.

Question:

Prior to going and getting the Epley(redone) have u noticed a Latency and Fatiguing when u do the MEP or they do the Epley (using the MEP as an example)....

---when u go into the first MEP maneuver(position) a delay of 15 to 45 or so seconds before a vertigo type spinning takes place and if u get that spinning in that MEP position(1st) and u hold that position does it subside after 15 or 45 seconds?

And if not in the first MEP maneuver(position) does it happen in any of the remaining(3) MEP maneuvers(positions)?

Do you know what ear has the injury?

...."Also, I had finally gotten a sense of peace about all this crap because for my 4th Epley, I was able to do the MEP to successfully treat it. I tried to treat myself this time, and since it was in the horizontal canal, it didn't do any good.".....

What made u think the MEP was successfull?

What was ur indication that...."tried to treat myself this time, and since it was in the horizontal canal, it didn't do any good.".....



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I agree that the chair might be the way to go ... my dr. said that the chair can get people into positions that you just can't do otherwise and they are able to clear patients that they haven't been able to clear manually ... so if it happens again, I am very hopeful that the chair will be working!

Here are my best attempts to answer your questions:

Question:
"Prior to going and getting the Epley(redone) have u noticed a Latency and Fatiguing when u do the MEP or they do the Epley (using the MEP as an example)...."

Answer:
Yes - each time I had the Epley done (or when I did the MEP), I had a latency/nystagmus/fatigue in the 1st position. Usually nothing or little in the 2nd or 3rd positions (from what I remember now?), and then usually some latency/nystagmus/fatigue on the 4th position.

Question:
"Do you know what ear has the injury?"

Answer:
YES, it's my left.


Question:
"What made u think the MEP was successfull?"

Answer:
That's an interesting question - because when I did the MEP on my own, I had the latency/nystagmus/fatigue in the first position only and I thought it didn't take and I continued with the MEP once a day on the following days (with no spinning). I did notice that in the following days the spinning vertigo was gone and I also noticed a slight sense of falling backwards, and my PT said that is usually a good sign. (?) Plus, I had several weeks after that where I did the MEP daily and continued to feel good - so I assumed that the MEP worked.

Question:
What was ur indication that...."tried to treat myself this time, and since it was in the horizontal canal, it didn't do any good.".....

Answer:
When I tried to do the MEP this time, I felt a very short burst of nystagmus in the first position and another short spin in the second position and then nothing else. But, afterwards, I still had spinning vertigo when moving my head in certain positions. When I talked to my PT (she is kind enough to have given me her cell # so I can call her after hours), she suggested that maybe it was in the horizontal canal and to test by rolling from my back to the side - and when I did this I definitely had spinning. She suggested to try the log roll. When I did that, I had nystagmus when laying on my left side and it just kept going and going and didn't seem to want to fatigue, so I freaked out and sat up! (When I went to the PT at the dr.'s office the next day and layed on my left side, I had the nystagmus again that seemed to go on and on and on, but it did finally fatigue.)

Unfortunately, when all this stuff is going on, it's hard for me to remember exactly what happened. But, I do know that each time I've had the Epley or MEP, the spinning stopped and in the following days I was able to lay flat on my back, move my head in any position, etc. with no problem for weeks at a time (until the next round hit). Right now, I'm still keeping my head upright following this last procedure so it's hard to know for sure if the spinning is gone - but overall I feel better, so I'm hoping it's cleared.

Thanks again for your help with this!! Any insight is greatly appreciated.

Hi Ssdizzy

Answer:
Yes - each time I had the Epley done (or when I did the MEP), I had a latency/nystagmus/fatigue in the 1st position. Usually nothing or little in the 2nd or 3rd positions (from what I remember now?), and then usually some latency/nystagmus/fatigue on the 4th position........

Excellent---results---classic!

---it sounds like their in the Posterior Canal & not the Horizontal(Lateral) canal

---if that's true---and my guess is---its more likely then not.

---Lateral canal BPPV (most common atypical variant) but only accounts for about 3-12 percent of BPPV cases...

---so while possible---it would seem remote---especially---with the very experienced medical personnel---handling ur treatment/Dx---and especially when ..." most cases are seen as a consequence of an Epley maneuver" not done correctly----and especially with the symptoms ur getting when doing the MEP.......

Answer:
That's an interesting question - because when I did the MEP on my own, I had the latency/nystagmus/fatigue in the first position only......

---That's good!

----If u take a look at the instructions for the MEP:

..."This maneuver should be performed three times a day. Repeat this daily until you are free from positional vertigo for 24 hours".....

and I thought it didn't take and I continued with the MEP once a day on the following days (with no spinning)......

---U would do it(MEP) three times a day until there was no vertigo for 24 hours.... if after that occurrence---u wanted to do them daily u would do one---if a few days went by---without vertigo---and then when doing an MEP it occurred again---then u would go back and follow the instructions---until u did three without any problems....

I did notice that in the following days the spinning vertigo was gone and I also noticed a slight sense of falling backwards, and my PT said that is usually a good sign. (?) Plus, I had several weeks after that where I did the MEP daily and continued to feel good - so I assumed that the MEP worked........

---Another indication of Posterior Canal problem.....

---Ear Rocks---some research is now showing are more like a "slurry" this slurry builds up until it reach a critical mass in weight/volume & triggers BPPV---if that research turns out to be true---then---it could explain---the need for repetitive Epley's/MEP's....which could be happening in ur case(and others)---since anyone who has cleaned out "slurry" or rocks---knows it is easier to get a couple of rocks out---then move a "slurry" mess out of anything---on the first(or more) go arounds.....

---All of that notwithstanding---it sounds like Posterior Canal BPPV---with the ear rocks/slurry(depending which u buy into) slipping back into the canal---which is not unusual---in the beginning of BPPV---at all---for most/some....

---BPPV as it turns out---for most---is the easiest to fix---it does have a recurrence rate(see sticky)---that is higher with age---but if u can get beyond 5/6/7 year point---its not likely to return & with the MEP---at least u have some control---over it.....

Think I might try:

---Go for the Chair

---When/if next vertigo attack---MEP---following instructions & Video #2

---If that does not seem to work---Semont maneuver (MSM)---following instructions...& Video #1 (same article as MEP)

---For me--it took a good 13/14 months of on again off again MEP's to clear the Slurry/Rocks out and keep them out---yet a 24 months while working under a car---I had a touch of them again---did MEP's following the instructions---explicitly---and it was gone in less the 24 hours.....

:cool:

Thanks Subs!! That really helps. I guess I'm not thrilled about the slurry theory, but at least it would explain some things. I'm entering month 9 - so I'm hoping for the best that maybe my timeline will be closer to yours than the 5/6/7 year timeline!! Thanks again. You are a wealth of info.

Thanks Subs!! That really helps. I guess I'm not thrilled about the slurry theory, but at least it would explain some things. I'm entering month 9 - so I'm hoping for the best that maybe my timeline will be closer to yours than the 5/6/7 year timeline!! Thanks again. You are a wealth of info.

Just a clarification----

The 5/6/7 year time line is only for recurrence,i.e., people who go perhaps 2 or 3 years with no problems then have a reoccurance---was about 5 years---until recent research showed a couple of recurrences at the 6 and none at 7 years and beyond----many---have no recurrence at all.

Think---with the good medical u have---u'll get this one sorted out---and be clear....hard to think that way---but for most true!!



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