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Old 01-23-2009, 11:21 AM   #1
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How to determine which ear in BPPV?

Hi -
I got classic BPPV symptoms 2 days ago (happened when I rolled over to get out of bed) and of course I immediately rushed to the internet. Luckily there's a lot of information and my situation seems to perfectly match the descriptions of BPPV. I am hopeful that the symptoms go away on their own - if they don't I'll be making an appt with a dr next week. However, this weekend I want to try the Epley maneuver at home. It seems like it couldn't hurt and possibly could be all that's required.

My main question is - how do I know which ear is considered affected. If I tip my head to the right and then look up at the ceiling nothing happens. If I tip my head to the left and look up the spinning starts after about 5 seconds. Does that mean it is my left ear that is affected?

I've seen the claymation video that shows how you can tell by laying down and turning your head to one side or the other. So, I just tried that here on the floor at work -ha - and it definitely only happens when I turn to the left.

I guess I've answered my own question but if anyone has any advice or guidance on the Epley and doing it at home vs. having it done by a dr. the first time -- please let me know what you think.

Thanks.

 
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Old 01-24-2009, 07:29 AM   #2
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Re: How to determine which ear in BPPV?

Yes - I think you did answer your own question! It would be my guess that it's your left ear that's affected.

I'm not sure if you've already tried the Epley or not - but if you do try it on your own for the first time - the thing I would suggest to remember is that certain positions of the Epley will make you feel very dizzy - the key is not to move when you get dizzy. Just stay in that position and know that the dizziness will subside (it may seem like an eternity - but it usually subsides within 15-30 seconds). Also, sometimes you'll get a big spin when you sit up at the end, so I always have someone there with me to help hold on to me.

If that doesn't clear it up - I would definitely try getting in to to see a neurotologist or vestibular therapist - the Epley is done to treat crystals in the posterior canal, but there are two other canals that can be impacted and there are other maneuvers for those - so a specialist can help you determine the appropriate canal and maneuver. (Although chances are it's your posterior canal and the Epley will clear it up.)

Let me know how it went!!

 
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Old 01-25-2009, 07:50 AM   #3
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Re: How to determine which ear in BPPV?

Hi ssdizzy -
Thanks for the reply.
I did try the Epley yesterday at home with my husband there for support. It really did seem to work. Hours later when I tried turning my head in the position that was a surefire spin trigger (looking up as if at an airplane over my right shoulder) nothing happened. So I was thrilled.

When I went to sleep I didn't feel bedspins the first few times when I turned over but later in the night I did & when I got up this morning I did.

I know it could take several days of doing the Epley so I'm going to continue and try to do it twice a day for a while before I call a dr. I know what you're saying about it being another canal so possibly what I'm doing won't work - hopefully I'm not making things worse in any way.

One thing I forgot until now is that I should've slept elevated rather than flat last night so I'll do that the next few nights. Does it mean that once the crystals get repositioned you need to stay with your head upright or they'll fall back out? What ever gets them to "latch" back on where they should be?

And I've never seen much about what is believed to cause them to move out into the canals other than head trauma which I've not had. I can't think of anything that would've made this happen although the night it started was after a yoga class which made we wonder if that was part of the cause. It may have gotten the crystals moving around but I don't think that is why they were out of position to begin with.

Oh well...a few more days of listing like a drunken sailor and then I'll go to the dr.

 
Old 07-14-2009, 12:10 PM   #4
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Re: How to determine which ear in BPPV?

I also have been having problems with off and on vertigo for a few weeks that cleared up about two weeks ago, then came back this morning with classic BPPV symptoms. I say classic --- I get brief spinning vertigo from looking down or up and if I do the Dix-Hallpike test, the room spins in a clockwise roll. The spinning lasts about a minute then stops, and when I sit up again it spins the opposite way for a few seconds. If I do the test over and over, I get less and less dizziness each time. The only thing that isn't classic is that when I'm on my back with my head hanging down, I get spinning regardless of which way my head is turned. It's always in the same direction, clockwise (rolling, not yawing), then reverses when I sit up. So is this still BPPV, and which ear is it in? Or is it in both? From what I read, with the affected ear down the top of the eyes should beat towards the ground, towards the affected ear. I think that means that if the right ear is affected, then the rotational fast phases should be clockwise, which they would be if I'm seeing everything spin clockwise. Is this right?

I should say that I saw an ENT for my earlier vertigo, but couldn't get in before it had already cleared up. He did an ENG which was within the normal range. From my symptoms he thought I had had BPPV in the left ear, and another doctor saw signs of a middle ear infection in my left ear. If I had an inner ear infection, wouldn't it be unusual to then get BPPV in the opposite ear?

 
Old 07-14-2009, 06:55 PM   #5
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Re: How to determine which ear in BPPV?

If you do the Epley, then don't lay flat for 24 hours, avoid alcohol, and don't bend over to get something off the floor. So you want to keep your head upright to give those "crystals" a chance to settle in where they belong. That's probably why it came back. Good luck!

 
Old 07-15-2009, 10:43 PM   #6
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Re: How to determine which ear in BPPV?

I couldn't figure out which ear is the bad one but went on the assumption that it was the right one and did an Epley (actually more than one) yesterday. No joy. So last night I did an Epley for the left side and today am feeling a lot better. I can lie on my back without the room going into a spin, though I was a little off kilter. I didn't even sleep propped up, though I do understand that is recommended by most specialists. So I'm still not sure which side is giving me trouble, but I seem to have fixed it. If it comes back, I'll have to make an appointment for September (just in case it doesn't clear up on its own before then!)

 
Old 07-17-2009, 08:46 PM   #7
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Re: How to determine which ear in BPPV?

I was successful with the Epley back when this first occurred in January.
Today, out of the blue I felt it again. My husband helped by watching my eyes to test and yes, they did the jumping motion (nystagmus - can't remember the spelling). So I'm going to be doing Epley again.

Is it odd that it's on the opposite side this time? I would think a recurrence would be in the same ear. Guess not. I never did know why I had the first bout - no bump on the head or fever or anything I can think of -- and now within 7 months to have it again but in the other ear. Hmm...weird.

Do you think sleeping upright matters a lot? I don't know that I can do that - or that I'll actually be getting any sleep. What if I just don't lie on the affected side? Can't remember what I did in January.

At least I know this time that Epley will work & this should only last a few days (fingers crossed).

 
Old 07-25-2009, 09:28 AM   #8
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Re: How to determine which ear in BPPV?

Just thought I'd add my two cents on the sleeping upright thing - I personally don't think it matters. I have had several episodes of recurrent BPPV and there did not seem to be any link between the recurrence and whether or not I slept at an incline. In fact, sleeping at an incline wreaked havoc on my back and neck, so I personall didn't bother with it. I know all the advice says you should sleep on an incline, but it didn't seem to matter much in my case.

 
Old 07-26-2009, 08:59 AM   #9
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Re: How to determine which ear in BPPV?

I didn't sleep upright either this time and it didn't affect my situation. I don't know how this could resolve so fast but it only took 2 days worth of Epley-ing before I no longer had the symptoms. They were very much the "classic" symptoms of room spinning when I looked up and in one direction, not the other, so I don't think I misdiagnosed myself. I'm just surprised (happily) that it would clear up so fast.

 
Old 10-09-2009, 05:13 PM   #10
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Re: How to determine which ear in BPPV?

How are you doing with this now...2 1/2 months later? I was just diagnosed with this and the Dr. did the partial repositioning with me today. I'm also taking meclizine (75mg a day). Yesterday and last night were awful. I'll be sleeping upright again (not looking forward to that). Also, I find that when I read or use the computer my head feels werid....have you ever experienced that?

Thanks.

 
Old 10-11-2009, 08:05 AM   #11
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Re: How to determine which ear in BPPV?

let me walk: not sure if your question was to me but I'm doing fine (knock wood). It gives me great comfort to know that the Epley maneuver works like a charm and if I have future episodes of vertigo I'll know not to panic.

I wonder what it is about my inner ears that is causing this - I wonder if it is the inverted postures I do in yoga that get the little "rocks" out of position? I guess I'll never know but I'm happy to know there's a solution.

Good luck with your recovery. I know sleeping upright is not easy.
I haven't felt the sensation you describe with reading or looking at the computer but it makes sense that your vision could be affected. Mine was mainly just when I tipped my head a certain way I'd start spinning and need to grab onto something to stay on my feet.

Hope you are feeling back to normal soon - keep up with the Epley - it really works.

Leslie

 
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