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Suggest Treatment For Severe Dizziness Due To BPPV After Having Epley Manouvre
Question: I was diagnosed with bppv 2 months ago but have not had vertigo only dizziness, tinnitus, headaches, insomnia. The ENT prescribed SERC 8mg 3x a day and I also take Bromazapine for anxiety. My problem is I stupidly tried the Epley manouvre at home yesterday and now my dizziness is much worse especially if I look up or down. Most comfortable position is lying down with pillows behind head. Should I try to get exercise, continue with vestibular exercises (mild eye exercises- not epley!) or should I just keep resting for a few days? I live in small town in Spain and on weekend only limited emergency services which I don't really need. But I have low blood pressure so some concern there.
Brief Answer:
Please see the answer below...
Detailed Answer:
Hi
Thanks for posting the query. I have gone throught he history thoroughly and understood your problem. I will try my best to help you out with this.
1. Let me be clear to you, for BBPV, no medicine works. Hallpike's maneuver has to be done to confirm the diagnosis and if found to be having BBV then Epley's corrective measure is done in the office to relieve the same. The best part of BPPV is fatigability. If you repeatedly move your head towards the affected side, the dizziness passes off. I doubt why your doctor did not perform Hallpike’s at the first instance.
2. Secondly, cervical spondylosis can present with similar features and your dizziness worsens on neck movement. As you have mentioned, your dizziness reduces on placing the pillow below the head; which is indicative of cervical spondylosis.
3. Low blood pressure can also cause dizziness. Hence, you can increase the salt content in your diet.
4. To sum it up:
a. Avoid neck movements, vestibular exercises and Epley's procedure.
b. Try increasing the dosage of Serc to 16mg three times a day.
c. Consult your doctor after the weekend.
Hope I have answered your query. I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Please see the answer below...
Detailed Answer:
Hi
Thanks for posting the query. I have gone throught he history thoroughly and understood your problem. I will try my best to help you out with this.
1. Let me be clear to you, for BBPV, no medicine works. Hallpike's maneuver has to be done to confirm the diagnosis and if found to be having BBV then Epley's corrective measure is done in the office to relieve the same. The best part of BPPV is fatigability. If you repeatedly move your head towards the affected side, the dizziness passes off. I doubt why your doctor did not perform Hallpike’s at the first instance.
2. Secondly, cervical spondylosis can present with similar features and your dizziness worsens on neck movement. As you have mentioned, your dizziness reduces on placing the pillow below the head; which is indicative of cervical spondylosis.
3. Low blood pressure can also cause dizziness. Hence, you can increase the salt content in your diet.
4. To sum it up:
a. Avoid neck movements, vestibular exercises and Epley's procedure.
b. Try increasing the dosage of Serc to 16mg three times a day.
c. Consult your doctor after the weekend.
Hope I have answered your query. I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2542 Questions
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