Vertigo is a terrible feeling. The world spins around you and you may feel unsteady or nauseated. While there are many possible causes of vertigo, the most common is a condition called benign paroxysmal positional vertigo (BPPV). The condition occurs when the calcium crystals in the posterior canal of the ear come loose and start floating where they don’t belong. The best treatment for BPPV is to get them back in their proper place, usually through a series of head movements. How can you learn what the proper movements are?
Web-Based Instruction for BPPV:
A simple repositioning maneuver has been recommended to correct BPPV. Some audiologists help patients perform this maneuver, but not everyone has access to an audiologist. Korean researchers tested whether they could treat BPPV successfully by providing web-based video instructions (JAMA Neurology, Jan. 17, 2023). They recruited 585 patients and randomly assigned half to the video instruction. 72 percent of those performing the maneuver and 43 percent of those in the control group resolved their vertigo. The authors concluded that people with recurrent BPPV can benefit from web-guided self-treatment.
An earlier issue of that journal offers a case report from Germany (JAMA Neurology, Jan. 9, 2023). These authors offer video links to the diagnosis and a demonstration of the SémontPLUS maneuver.
What Is the Best Treatment for BPPV?
Q. I read in your newsletter that supplements of vitamin D and calcium might prevent recurrences of benign paroxysmal positional vertigo (BPPV). I’ve been taking vitamin D and calcium for years. I still got BPPV, which made my head spin.
My neurologist referred me for PT. The therapist did the Epley maneuver twice on my first visit and repeated it again later. It worked like magic! Now if I think the vertigo is returning, I try to do it myself at home.
The Value of Vitamin D for BPPV:
A. People who are low in vitamin D appear to benefit more from the supplements to prevent BPPV recurrence (Neurology, Aug. 5, 2020). The dose was 400 IU of vitamin D and 500 mg of calcium carbonate twice a day. Those who began the study with adequate vitamin D levels did not take supplements.
What Is the Epley Maneuver?
The Epley maneuver is designed to reposition the calcium crystals in the ears and is the best treatment for BPPV. It is not too hard to do these movements at home. To help you learn how, here is a link to a recent video in which a PT demonstrates the moves.
You can learn more about the diagnosis and treatment of vertigo in our interview with Dr. David Kaylie, medical director of the Duke Vestibular Disorders Clinic. It is Show 992: Overcoming Vertigo.
How have you overcome BPPV? Please share your experience in the comment section below.