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Old 04-22-2005, 04:52 AM   #1
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BPPV help needed!!

Is there any other treatments at all for BPPV apart from epley and brandt daroff.

I have had BPPV for the last couple of years and have had 24/7 dizziness at some level. I usually have 1-3 BPPV attack per week.....yes per week!! However, they are usually less severe the more frequent they are. However, still very unpleasant.

However, before last week I went a whole month without an attack and the other usual dizziness symptoms improved in leaps and bounds. To the point of being very noticable improvements. However this week I have had 3 attacks. The first one being the worst in a really long time.....I already do the MEP as soon as I get a bppv attack and do the brandt daroff daily.

Any suggestions??

 
Old 04-22-2005, 06:37 AM   #2
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Cool Re: BPPV help needed!!

Quote:
Originally Posted by star803
Is there any other treatments at all for BPPV apart from epley and brandt daroff.

I have had BPPV for the last couple of years and have had 24/7 dizziness at some level. I usually have 1-3 BPPV attack per week.....yes per week!! However, they are usually less severe the more frequent they are. However, still very unpleasant.

However, before last week I went a whole month without an attack and the other usual dizziness symptoms improved in leaps and bounds. To the point of being very noticable improvements. However this week I have had 3 attacks. The first one being the worst in a really long time.....I already do the MEP as soon as I get a bppv attack and do the brandt daroff daily.

Any suggestions??
Hi Star

...."have 1-3 BPPV attack per week".....

By attack do you mean "spinning vertigo"????

Is the BPPV occurring on only one side & do you know which??

....." went a whole month without an attack and the other usual dizziness symptoms improved in leaps and bounds"....

That would indicate---"rocks out" and compensation taking place....as it should....during that compensation period did you continue to do the B/D???


 
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Old 04-23-2005, 03:16 AM   #3
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Re: BPPV help needed!!

Hi Subs

By attacks I mean spinning vertigo. Most of my bppv attacks just have spinning vertigo when my head is tilted to the right but increased dizziness and distortion in all positions.

BPPV affects my right side, always only my right.

During the good month I continued doing the b/d and all other exercises I had been doing (vest rehab exercises). I do 2-3 hours of exercises per day.

Any ideas would be greatly appreciated!

Leigh

 
Old 04-23-2005, 09:51 AM   #4
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Cool Re: BPPV help needed!!

Quote:
Originally Posted by star803
Hi Subs

By attacks I mean spinning vertigo. Most of my bppv attacks just have spinning vertigo when my head is tilted to the right but increased dizziness and distortion in all positions.

BPPV affects my right side, always only my right.

During the good month I continued doing the b/d and all other exercises I had been doing (vest rehab exercises). I do 2-3 hours of exercises per day.

Any ideas would be greatly appreciated!

Leigh
Leigh

Understand

My idea--- would--- be to drop the B/D---don't think it is helping you---and maybe putting the rocks back---since your sure its your "right side--only"----move exclusively to the "MEP"---for the "right side" only.

Assume you printed the instructions and downloaded the video(#2) from the web site.

Need to do them as the instructions direct----don't vary at all----and as it says---three sets---(3 maneuvers each set)----without---a spin---stop---or after five to six days with no success----no VRT's---during that period---rocks got to get out(step # 1)----after that your ready for VRT(Step #2)---and compensation.

....."I mean spinning vertigo. Most of my bppv attacks just have spinning vertigo when my head is tilted to the right.."....

And does that vertigo have a "latency & fatiguing" to it---usually on the first and second maneuver of the set????----that is a key/extremely important indicator---can not overstate---it's importance!!!!!!!!

...."but increased dizziness and distortion in all positions."......

The "dizziness" is associated with the lack of compensation---the VRT's are designed to deal with that----after the rocks are out & stay out---compensation---full---can not take place---until the rocks are out---and stay out.......

...."distortion"-?????????

I think your close---obviously the rocks were out---during your good month---some how they went back in---or fragments/splinters---drifted in---I strongly suspect---that---the B/D + MEP + 2- 3 hours of VRT is causing it---think---need to slow it down & focus on getting the rocks out---with the MEP(right side only)...

If it was me---I would try that.....---with a month of "good"---think if the rocks stay out---compensation will/can take place--and your out of there!!




 
Old 04-23-2005, 02:14 PM   #5
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Re: BPPV help needed!!

Subs,
When you were going through this did you find that not sleeping on your right side (affected side) was helpful? I have been avoiding sleeping on that side and either sleep on my back or on my left side.
Still doing my MEPs religiously, have had some great days but am back in the dumpster (hopefully this is just temporary), really working through the vrt and doing lots of balance exercises. My balance is good but I have set some high goals.
Thanks for staying on these threads,

 
Old 04-23-2005, 07:14 PM   #6
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Cool Re: BPPV help needed!!

Quote:
Originally Posted by firechick
Subs,
When you were going through this did you find that not sleeping on your right side (affected side) was helpful? I have been avoiding sleeping on that side and either sleep on my back or on my left side.
Still doing my MEPs religiously, have had some great days but am back in the dumpster (hopefully this is just temporary), really working through the vrt and doing lots of balance exercises. My balance is good but I have set some high goals.
Thanks for staying on these threads,
Hi Firechick

Yep & Yep & Yep and a double Yep---never ever would I sleep on the right side---took about 1 1/2 years---to feel like I even---wanted to try---and still---do not do it often---now----even when I get no---unusual feeling---at all---when I do it----I did it a couple of times---before I fully compensated---and---felt strange---the next couple of days----figured---the brain/body---was giving me a message---and had nothing to prove by doing it---so I skipped it----figured when the time came---the brain/body---would let me know.

...."some great days but am back in the dumpster (hopefully this is just temporary)".....

Yep it temporary---it is just the brain's equilibrium center working the the various equations---for the repertoire of movements----for me it was two steps forward---one back----every week in the beginning---then two/one---every couple of weeks---then three/one every week----then three/one every three weeks, etc... until an occasional "blip" once a month---then once every three, etc....

----until it just recedes from view in the rear view mirror...


----just takes time......can not be rushed----all of those pesky little neurons---got to reestablish/establish the clusters---which guide your movements---except for the last nano-second---which is done by the brain in real time---so as to adjust for force and speed, etc...of the movement

---even with your DNA containing more then a "billion" piece of information---to guide the cluster development---from inception---it still required each sensory neuron(cell) that made up the neuron cluster---this junk disrupted---time---to find/connect---with other cells that finally made up the neuron clusters---that contained---the preplanned movement templates---which allowed you to---move about---effortlessly---with almost no thought

---given that building the brain's neural network---a trillion(10 to the 12th) neurons connected by 10 quadrillion(10 to the 16th) synapses---was a daunting task---to begin with---putting a part of it back together---is prob not a "piece of cake"

---and whatever---the number of neuron connections involved---with balance and movement system may be --they(neurons) have to find each other---to connect---and---that can only be accomplished---when they---are firing at the same time---then---they connect---together---and ignore the information---all other neurons---that do not fire at the same instant in time---and the cluster(s) start to form

---that is why you will hear the neuro-scientist

---say "neurons that fire together wire together"---wallah---the cluster begins---it started in the womb

----kind of surprised---when people---think---you can rush the reestablishment of what this junk screwed up---quickly----the only difference---in time to fully recover---for anybody---is---how much of the cluster(connections) got "hosed" ---given that the "sensor" is healed/corrected,i.e., "rocks out" in the case of BPPV.

Conceptually---its deceptively simple---"sensor(s) & processor(s)"---in reality---it can be a nightmare---for all(patients & Doc's)---when one or both---get "hosed"


Last edited by Subs30; 04-23-2005 at 08:17 PM.

 
Old 04-24-2005, 12:37 AM   #7
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Re: BPPV help needed!!

Odd...I sleep on any side...yes, I get dizzy when I'm in an attack (meaning when symptoms first appear till I have no symptoms -- back to normal)..but lay quiet, it passes then I go to sleep.



My perspective....Star, you're waaaay overdoing the exercises. Just go about your daily functioning without babying too much.
I agree with Subs...stop the B-D exercises.

Too much stimulation I believe will actually hinder your progress rather than help.

Maybe I've just had it too long. It comes, it goes. Treat it, but function as normally as possible.

quincy
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Old 04-24-2005, 02:53 AM   #8
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Re: BPPV help needed!!

thanks for the confirmation Subs,

When I think back to my blip last weekend, I woke up on my right side (which I had been avoiding for months) and there you have it...a funny day with some symptoms.

Your scientific explanation was fascinating, and yes as conceptually simple as it sounds, asking humans to be patient and let the process work its way through is asking a lot. As a species we are impatient and want the fix yesturday (myself included!). Sometimes reading it as you present the information makes it easier to understand and for me, be more patient.

"figured when the time came---the brain/body---would let me know." I think this quote sums up a lot. We need to slow down sometimes and really listen to our bodies and what our symptoms are telling us. That gut instinct is there to protect us and we need to listen to it.

Have a great weekend, off for my 24hour shift (Luckily I only have one a month)

 
Old 04-26-2005, 12:44 AM   #9
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Re: BPPV help needed!!

Hi Subs

So just to make sure I am understanding correctly....you are saying to do the MEP 3 times a day until there is no dizziness provoked or for 6/7 days (whichever comes first). Is that correct. Currently I do it 2-3 times a day after an attack but don't continue it when I am crystal free.

When you say 'latency and fatiguing' nature I am a little unsure. When I have a medium level attack if I stay in a position for 1-2 minutes the spinning tends to slowly settle but nowhere near normal. But when it is a bad attack the spinning settles only slightly and usually I find it really hard to stay in the provoking positions for very long at all. When I am in this state I get a timer while doing MEP and make sure I stay at least 2 minutes in each head position. When it is a medium level attack I usually wait 30 seconds after the spinning subsides. Im interested as to why the latency/ fatiguing is such an important factor - please expand on this!

''...."distortion"-?????????''

By distortion I mean I find it hard to keep my visual world accurate. Things move and jump. But I have been doing a fair bit of visual therapy and this has improved heaps.

The 2-3 hours of exercises per day includes 2 sets of vrt exercises and walking. Personally I don't feel as though I am overdoing the exercises because I have been doing the same amount of exercises for over a year and have improved hugely since doing them. It isn't like it is a recent change which has triggered the bppv. The main problem I have now is the bppv.

Thanks!!

 
Old 04-26-2005, 05:07 AM   #10
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Re: BPPV help needed!!

Hi Star803
I believe the phrase "latency" is when you go into a vertigo inducing position it will take a few seconds before the spinning begins. Near the end of my repositioning (after the second day of doing the MEP) I could sometimes wait up to 20 seconds in the first position of the MEP before the spin would happen. "Fatiguing" means if you repeat the same head position that induces the vertigo after two, three or four trys the vertigo stops and you can't bring it on at all in that position. This happens sooner and sooner as you get those nasty little rocks out of the way.
Subs can fill in the missing elements from my explanation but this is how I understand those characteristics.
Hope it helps and you are finding some relief in the MEP. IT works wonders for me!
Good luck

 
Old 04-26-2005, 07:59 AM   #11
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Cool Re: BPPV help needed!!

Hi Star

Firechick's got a good explanation posted---couple of items to amplify her--post...

..."MEP 3 times a day"

---MEP 3 times --but spaced out over a 24 hour period...not 8, 12, etc...24 hour period as the instructions say....

..."until there is no dizziness "....

The MEP is to get the rocks out---not to correct "dizziness"---that is a function of the VRT's

---On the occasion when you do a MEP and you get no vertigo in any maneuver of the that MEP set at all...then you continue to do three more MEP sets(containing three maneuvers in each set)---if on completion of the third MEP set---still no vertigo---then rocks are out---for now---of course depending on what you do after that + time---could slip back in.

...."or for 6/7 days"....

If after doing the MEP's---three MEP sets per 24 hour period--for 6/7 days----you still are getting vertigo----the MEP is/has not worked.....


..."When you say 'latency and fatiguing' nature I am a little unsure"....


In "typical BPPV" (not all)

..."Vertigo and a typical twisting type of nystagmus ensue after a latency of two seconds and last about ten seconds(fatigue)...."

above from Northwestern Univ Dr Hain...web site....

It is important---because---it is one of the best symptoms---available to Doc's to Dx---that your prob is really BPPV---and not Lab or VN---although Lab/VN--can cause BPPV....and the best way for you to know when the rocks are out....

It is movements of the ear rocks in the canal that causes the latency and then fatiguing.....the fluid in the canal is thought to have the consistency of soft soap/dishwasher soap, etc...---it does not have the consistency of water....and the rocks are thought to be suspended in the fluid..

The rocks "a body at rest" will tend to remain at rest unless acted on by a force "positioning of your head"---but they don't move---immediately---because of their mass---takes---a build up---of force---to overcome--the mass---inertia----wallah "latency"

The rocks "now a body in motion" will stay in motion---until---the loss of the force---that got them started---or are acted on by an equal and opposite force---since your head is no longer being positioned the force to keep them in motion is no longer there---"fatigue"...

So when you do the MEP---turning your head to the right---and---laying down---on that side--provides the force that---(if there in the canal)--starts the rocks movement---and you get spin/vertigo---because you have a mass---on one side of your head---in the canal---and not in the other side canal---so the brain gets two conflicting vestibular inputs and says---I'm out of here

-------however after---you---lay there---counting for 30 seconds...etc...---or until the spinning stops(indicating that the rocks are not moving in the canal any more)----i.e., the force that set the rocks in motion---starts to dissipate---since---your no longer positioning your head-------their still in there just not moving---the spinning stops---because with no rock movement---the signals from the right and left vestibular system--are equal/balanced for your head's spacial position---in respect to "gravity"---...but you still feel--wierd...since the rock...is still in there on---the right side---so the brain--is till trying to figure out what the heck is going on...

....."The main problem I have now is the bppv".....

What did you have before...???

Healthy to remember that the "latency & fatiguing" is for typical BPPV---there are other kinds---as you can see---from the info archive "BPPV" post..


Last edited by Subs30; 04-26-2005 at 01:20 PM.

 
Old 04-30-2005, 07:09 PM   #12
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Re: BPPV help needed!!

Subs......I'd like to pipe in here and give my understanding -- how it was explained to me by my doctors -- about latency and fatiguing. Does this make sense to info you've researched?

the brain's perception is what causes the latency and fatiguing. latency...the brain's waiting for the signals from the canals (ALL the canals), but hey, one's missing....vertigo (and/or other symptoms) happens. When the same position is repeated -- repeated...the brain recognises it as more "normal" and lessens the overcompensation. Fatiguing doesn't mean that the symptoms will necessarily stop...it does mean that the symptoms will lessen in intensity (a classic of BPPV).

It's not the otoliths that cause it, it's the brain's perception of no/changed information from whatever canal is affected by the otoliths (crystals).

The position of where they are in the canal or on the cupula affects the message to the brain and in turn it creates the physical consequences of vertigo, nystagmus, dizziness, nausea, stilted walking, veering off to one side..etc.

The rocks don't cause the sensations, it's the brains perception and interpretation of the message received and how it compensates for it. That's why for BPPV, surgery to cut the nerve from the ear to the brain is suggested.

I still think that someone needs to invent a kind of skin or netting that can be put over the otoliths to keep them from floating around. Seems good in theory tho.

Hope tomorrow is a feeling well day.

quincy
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Last edited by quincy; 04-30-2005 at 07:14 PM.

 
Old 05-01-2005, 05:24 AM   #13
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Re: BPPV help needed!!

I am not sure which explanation is correct, (I'll buy both/either of them) all I know is that both latency and fatiquing are classic BPPV. Although I don't get the spinning anymore, I still, on occasion get a very weird feeling when I lay down too fast, like at the gym when I am on a mat ready to so some sit-ups. I get this very heady feeling like the old spin is coming on, but it doesn't. It too passes, does that mean there are still fragments of a rock in the canal, or is that a compensation thing?

 
Old 05-01-2005, 10:55 AM   #14
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Re: BPPV help needed!!

...Low potassium will trigger BPPV attacks and I also suspect MSG for my latest episode. Any of the electrolytes may cause the same thing so Sodium, calcium, magnesium, and potassium may all need to be kept in correct levels.
...I have seen drastic improvement in my overall dizziness and vertigo (I also have Menieres) by eliminating food allergies and going on a diet of low to medium glycemic foods.
Rick

 
Old 05-01-2005, 01:28 PM   #15
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Re: BPPV help needed!!

Quote:
Originally Posted by Katkin
Hallo... just wanted to say I was doing a search for Modified Epley Manoeuvre on that famous search engine that starts with G lol (I want to start doing it and I'm not TOTALLY sure how to do it) and lots of good info on BPPV came up (not just to do with Epley).
It is in the Information Archives---the first post on this board---Under:

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

Article - [url]http://www.neurology.org/cgi/content/full/63/1/150[/url]
Video - [url]http://www.neurology.org/cgi/content/full/63/1/150/DC1[/url]

 
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