Dizziness and how we can help

Something a little bit different this time – dizziness.  A horrible symptom which can really get in the way of everyday life.  Needless to say there are lots of different causes of dizziness (many of them fairly benign and easy to treat), and if you have recently started with dizziness, having not had it before, then your first stop should be your GP.  If they are not concerned, or you need further help, then do get in touch!

One common cause of a feeling of dizziness is Benign Paroxysmal Positional Vertigo.  For obvious reasons, this is commonly referred to as BPPV – much more pronounceable! BPPV is a common vestibular disorder that causes brief episodes of vertigo and dizziness which are most commonly related to changes in head position.Typically people notice it most when turning their head on the pillow at night. It can come on for no obvious reason, but sometimes comes on after a bump to the head or whiplash type injury, a period of prolonged changed head position eg looking up for long periods when painting a ceiling.

It occurs due to the displacement of small calcium carbonate crystals (called otoliths), from the central chamber (utricle) into the semi-circular canals of the inner ear. These crystals can cause a blockage of the normal fluid movement around the canals, leading to inappropriate signals being sent to the brain, thus causing vertigo.

BPPV can significantly impact quality of life, leading to dizziness, imbalance, nausea, and even falls. Diagnosis of BPPV is often confirmed through the Dix-Hallpike manoeuvre. We can do this here in the clinic to determine whether BPPV is the cause of your symptoms.

The Epley manoeuvre, also known as the canalith repositioning procedure, is an effective treatment for BPPV. Developed by Dr.John Epley in 1980, this manoeuvre aims to move the dislodged crystals from the semi-circular canals back to the central chamber, where they can no longer cause symptoms.

The Epley manoeuvre involves a series of head and body movements performed sequentially. It typically takes about 5-10 minutes to perform and involves you lying on your back on the bench and me moving you and your head in to different positions to allow the crystals to reposition. Some people may experience transient nausea, dizziness, or imbalance immediately following the procedure. However, these symptoms are generally short-lived and resolve within a few hours. I recommend you get someone to drive you to your appointment, and I usually recommend sleeping in a semi-recumbent position for the first night, to keep your head in a neutral position which allows the crystals to settle where we want them!

The effectiveness of the Epley manoeuvre is well-documented.Numerous studies have demonstrated its efficacy in resolving BPPV symptoms. The success rate ranged from 70% to 90% with a single treatment, and higher with repeated sessions.

So if you feel like that might be helpful to you, please do get in touch – I’m very happy to chat things through if needed

References

Hilton, M. P., & Pinder, D. K. (2004). The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo.Cochrane Database of Systematic Reviews, (2), CD003162.

Froehling, D. A., Bowen, J. M., Mohr, D. N., Brey, R. H.,Beatty, C. W., & Wollan, P. C. (2000). The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial. Mayo Clinic Proceedings, 75(7), 695-700.

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