Vertigo and the Epley Manoeuvre

Dizziness can sometimes be caused by loose crystals (‘otoconia’) in the inner ear, which is known as Benign Paroxysmal Positional Vertigo (‘BPPV’).

These crystals normally participate in the body's balance, but when they separate from the tectorial membrane, they interfere with the transmission of information to the brain and cause balance problems and vertigo.

BPPV is the most common cause of vertigo, and is also the most common disorder of the vestibular (inner ear). Vertigo can be a debilitating condition that can limit your activities and make you feel quite sick. BPPV usually occurs in people over the age of 60; however I personally have been suffering from it since my early 50’s.

The signs and symptoms may include:

·         Dizziness

·         A sense that you (or the room) are spinning or moving (vertigo)

·         Light-headedness

·         Unsteadiness, loss of balance

·         Blurred vision

·         Nausea and/or Vomiting – that was a big one for me!

However, the scariest one is abnormal rhythmic eye movements (‘nystagmus’) which nearly always accompany the symptoms of BPPV (that’s how you know it is BPPV).

BPPV can come and go, with the nystagmus typically lasting only a few minutes at a time, but the loss of balance and nausea can last for hours or even days.  Episodes will commonly last for a few weeks, then disappear and reoccur few weeks or months later.

Activities that bring about BPPV are triggered by specific changes in the position of your head, such as tipping your head up or down, and by lying down, turning over or sitting up in bed. Mine always happened during the night or on waking up during serious period of stress.

My first episode happened upon waking up - I think the symptoms actually woke me. I completely freaked out thinking I was having a stroke or something. I managed to get out of bed and the spinning slowed and eventually subsided, but when I tried to lie down again it all started again. I did not know what was going on and the flickering eye movement really scared me.  I talked to a friend of mine that day telling her about it and she straight away laughed and told me about BPPV which she herself had experienced many times.  Luckily the name says it all, it is BENIGN and nothing as dramatic as what I was thinking!

The great news is that, fortunately, it is also the easiest type of vertigo to treat and it can be easily fixed with the Epley Manoeuvre (EM).

The purpose of the manoeuvre is to replace the otoconiae or "small calcium carbonate crystals" in the labyrinthine cavity, where they may be degraded. Rapid movements of the head are to be avoided, especially up/down movement for at least a week following the manoeuvre.

You can watch and learn how the EM is done here.

Before you try it yourself, see your doctor. If you have vertigo, you will need to confirm what type it is and which ear has the problem.

If BPPV is confirmed, your doctor (or more likely a physiotherapist) should know how to perform this procedure, and if not show them the youtube link above.

A warning - have a bucket close by; this could make you throw up after the exercise and make sure someone drives to the doctor/physio and back again as you will feel nauseous for a while after.

I must say that over the last 5 years since I got the condition, I have spread the word and made dozens of people, including physios, osteopaths and other therapists, aware of the BPPV condition and the EM solution as it seems not many people have heard of either. 

Fortunately, those people that do can now help family, friends and clients suffering this debilitating condition instead of referring them to the GP for medication.

So please don’t hesitate to share if you think it can bring relief to someone you know and love.

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