Common Positional Maneuvers Used in BPPV Testing and Treatment

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BPPV, Benign Paroxysmal Positional Vertigo, is a type of vertigo that occurs when the tiny calcium crystals inside the middle ear go loose & deposit inside the semicircular canal of the inner ear. These crystals are motion-sensitive, which means that they create problems with the balance & positioning of the body, especially in response to head stimulus.

BPPV symptoms include sudden onset of drowsiness, nausea, vomiting, & a sensation of the surroundings spinning or moving out of control. BPPV is also the most common type of vertigo a patient can experience, accounting for nearly 80% of all peripheral vertigo cases.

If you’ve been feeling dizzy, nauseous, & motion sick all of a sudden, especially if you have been feeling that your surroundings are spinning, then chances are you might be experiencing BPPV.

In this case, your doctor will likely administer certain BPPV tests on you to check for the exact cause of your symptoms. The exact results of the BPPV tests will determine which BPPV treatment strategy will be appropriate for your specific case.

In this article, we’ll tell you about some BPPV tests that your doctor will use to diagnose if you have been suffering from BPPV. We’ll also tell you about some BPPV treatments that will be given to you according to your condition.

BPPV test used for diagnosis:

Your doctor will likely make a diagnosis based on your symptoms, medical history, presentation at the time of diagnosis, & test results, including auditory or vestibular tests. One of the most common physical BPPV tests for its diagnosis is the Dix-Hallpike maneuver test. With this BPPV test, your doctor hopes to find out if you are indeed suffering from BPPV based on the results.

To perform this test, your doctor will ask you to sit on the exam table with your legs stretched out in front of you. They will then move your head 45 degrees to one side, & then help you quickly lie down on the table such that your head hangs a little over the edge of the table. They will then ask if you experience any vertigo symptoms & check your eyes for any signs of nystagmus.

it’s will then let you rest for about 15 minutes for any dizziness to pass, then repeat the test on another side. Whichever side you feel dizzy on, is your affected side. For example, if you feel dizzy when the doctor moves your head to the right, then you have right ear BPPV. And the reverse is true if you feel dizzy on your left side.

What happens after?

If the Dix-Hallpike maneuver didn’t give any particular results, your doctor might run some more tests on you to figure out the cause for your vertigo symptoms. However, if it does yield results, then your doctor will carefully study those & try to figure out the exact cause of your Vertigo.

In most cases, BPPV occurs all of a sudden, & recedes in due time. However, in some cases, it is possible for BPPV to be recurrent in nature & show up repeatedly. Your doctor will then, most likely, prescribe you some BPPV treatment methods & BPPV exercises like the Epley Maneuver for Vertigo to help relieve your vertigo symptoms.

Your doctor will likely perform the BPPV exercises for vertigo treatment themselves in their office for quick, effective removal of the loose calcium crystals in your inner ear. They might also teach you how to do the maneuvers yourself so that you can do those in the future if the need ever arises. There are various BPPV exercises & BPPV treatment methods that are helpful for patients. Some of these are listed below in the article.

Epley Maneuver for Vertigo:

The Epley Maneuver is the most popular exercise for Vertigo treatment, recommended by vertigo doctors. In fact, it is so popular that it is recommended as the first line of treatment to almost every other BPPV patient. It has also shown extreme effectiveness in BPPV treatment for patients. The original version is best performed by, or under the supervision of, a vertigo expert. However, the modified Epley Maneuver can easily be performed by the patients by themselves at home.

To perform the Epley Maneuver for left-ear BPPV, follow the steps mentioned below:

  • Sit on the bed in an upright position, and stretch your legs straight ahead of you with a pillow behind.
  • Turn your head to the left about 45 degrees.
  • Next, lie back quickly until your shoulders are placed on the pillow, & wait out any dizziness by staying in this position for about 30 seconds.
  • Turn your head 90 degrees to the right without lifting it. Hold this position for about 30 seconds.
  • Now turn your body in such a way that you’re lying on your right side. Wait for about 30 seconds to allow any dizziness to pass.
  • Finally, sit on the right side edge of the bed in an upright position, & wait for 15 minutes before getting up.

Repeat the exercises once every day until your symptoms subside for at least 24 hours.

Semont Maneuver for Vertigo treatment:

The Semont Maneuver is another BPPV exercise used in Vertigo treatment. It is also known as the liberatory manoeuvre. It is best performed under the supervision of a trained vertigo expert or a vertigo doctor.  To perform the Semont Maneuver for left-ear BPPV, follow the steps below:

  • Sit on the edge of a bed in an upright position & turn your head to the right about 45 degrees.
  • Quickly drop to your left and lay your head on the bed. Hold this position for about 1 minute.
  • Next, quickly move your body to the right. Try to do so in just one simple movement, without changing the angle of your head.
    Please note that in this position, you should be facing the floor.
  • Hold this position for about 1 minute before quickly returning to the starting position.

In case you have right-ear BPPV, turn your head to the left side first & drop your body to the right.  Sit still for at least 10 minutes after performing this BPPV exercise. Repeat once a day until your symptoms subside or show signs of improvement.

Brandt-Daroff exercises:

Brandt-Daroff exercises for BPPV treatment make use of the principle of gravity to move the calcium crystals lodged in the semicircular canal back to their original position in the middle ear.  To perform the Brandt-Daroff BPPV exercise, follow the steps below:

  • Sit on a bed & let your feet touch the floor.
  • Turn your head in the right direction about 45 degrees.
  • Lie down on your left side without moving your head. Wait for about 30 seconds to allow any dizziness to pass.
    If no dizziness occurs, wait for another 30 seconds before returning to the starting position.
  • Upon returning to the starting position, turn your head 45 degrees in the left direction & repeat the above steps in the right direction.
  • Return to the original starting position & wait for about 30 seconds.
  • Perform the Brandt-Daroff exercise in a set of 5 on each side.

Ensure that you wait for any dizziness to pass before standing up & getting on with your day. It’s ideal to perform one set in the morning & another set at night, continuing the regimen every day for at least 2 weeks. When performed in association with other vertigo treatment methods like medicines, lifestyle changes, etc., the Brandt-Daroff exercise has been shown to give good results in the stipulated time.

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