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Jai willimott
10-01-08, 11:27 AM
Hello all.

A happy new year to everyone.

<a href="http://www.meei.harvard.edu/patient/rauch.php" target="_blank"><a href="http://www.meei.harvard.edu/patient/rauch.php" target="_blank">http://www.meei.harvard.edu/patient/rauch.php (http://www.meei.harvard.edu/patient/rauch.php)</a></a>

This site has a video relating to BPPV and in that video the dissolving of the crystals is discussed.

I interested to hear from anyone that has some more information about this. I would rather have the crystals dissolve (if possible) as opposed to moveing them (with epley) and then haveing them fall back agian at some point..

Many thanks in advanced for your time.

Enjoy the dizzy free moments.

Jai

TomBoismier
10-01-08, 12:35 PM
Dr. Rauch was talking about how BPPV resolves spontaneously without treatment. There is no medical treatment to cause the crystals to dissolve, they break down through normal metabolic actions. Any medical treatment would also likely dissolve the crystals that are still in place and doing their job on the otoliths, causing BIG problems ...

These metabolic processes are much SLOWER inside the semicircular canals than they are in the vestibule (because there is less turnover of endolymph), so the best way to speed this dissolving process is to get the crystals out of the canal with the Epley, (or Semont, or barrel roll maneuvers depending upon which canal is involved and whether the crystals are clumped together or loose in the canal). Even better, if the problem really is BPPV, in trained and experienced hands (ie, not by doing it yourself at home, and not by having the GP do it for the first time in his career while reading from an instruction sheet ...) the Epley has an 80% chance of stopping the symptoms with a single 10 minute treatment (because there are no nerve bundles in the vestibule that the crystals can stimulate), with the other 20% resolved with a second or third treatmemt. Folks with pure BPPV who get the Epley are shocked, amazed at how much better they feel, IMMEDIATELY.

Keep in mind though, that MANY inner ear disorders can cause brief spinning vertigo triggered by head position. The Epley doesn&#39;t help with those at all. The classic signs of BPPV (delay, torsional nystagmus, cresendo-decresendo, reversal and fatigue) must be seen onthe Dix-Hallpike test to make the diagnosis. Also keep in mind that BPPV often co-travels along with other inner ear disorders (which act to dislodge the crystals from where they belong on the otoliths). In these cases, the Epley helps some (by resolving the BPPV part of the problem) but some symptoms remain due to the underlying inner ear problem.

If the Epley does not help at all, suspect that the diagnosis of BPPV is incorrect. If the Epley helps some, but doesn&#39;t get rid of all the symptoms, suspect an underlying disorder that is triggering BPPV. If the Epley works great, but symptoms return a few days or weeks later, over and over again, requiring repeated Epleys, also suspect an underlying fluctutant or progressive inner ear disorder. In all these cases, further diagnostic workup is needed to identify the underlying disorder so that it can be effectively treated.

nitty2
11-01-08, 01:57 PM
Hi Tom,
What happens when all the diagnostic tests show nothing? I&#39;ve had them all and nothing shows up. I don&#39;t know where to go from here. Neither does my doctor. I woke up to another round of room spinning vertigo this morning. I had it for two months. Had been through two weeks of VRT. Made a full recovery. Was released from VRT, doc told me the tests came back fine. Congratulations, I&#39;m dizzy free!
Two weeks of blissful non dizzy days. And now this. AGAIN! I&#39;ve stuck with the low sodium diet, I&#39;ve refrained from vigorous activity, I&#39;ve slept upright for three months, ect.
It use to be thought that I had bppv. then it was hydrops with bppv. Then the doctor said, maybe not. I&#39;m not sure of it anymore. I get headaches a lot now and its interesting to note that this came on exactly 24 hours after I started immunotherapy for my allergies. Not sure if there is a connection or not. Who knows, but I&#39;m tired. Just very tired of it all...

TomBoismier
11-01-08, 02:13 PM
<div class='quotetop'>QUOTE (nitty2 @ Jan 11 2008, 09:57 AM) <{POST_SNAPBACK}> (http://index.php?act=findpost&pid=40325)</div><div class='quotetop'></div><div class='quotemain'>Hi Tom,
What happens when all the diagnostic tests show nothing? ... I get headaches a lot ...[/b]</div>

More often than not, when the diagnostic tests are normal, it&#39;s migraine.

<div class='quotetop'>QUOTE (nitty2 @ Jan 11 2008, 09:57 AM) <{POST_SNAPBACK}> (http://index.php?act=findpost&pid=40325)</div><div class='quotetop'></div><div class='quotemain'>I&#39;ve stuck with the low sodium diet, I&#39;ve refrained from vigorous activity, I&#39;ve slept upright for three months, ect.[/b]</div>

Low salt only helps with the hours-long disabling spontaneous vertigo attacks of Meniere&#39;s/hydrops. Refraining from vigorous activity only helps in perilymph fistula. Sleeping upright for 3 months doesn&#39;t help with anything (unless your goal is to get a lot of neck and back pain ... http://www.dizzytimes.com/style_emoticons/<#EMO_DIR#>/wink.gif ) None of those treatment helped, so we need to start thinking about other possibilities.