Benign positional vertigo, often called benign paroxysmal positional vertigo, is a disorder of the inner ear characterized by repeated episodes of a spinning sensation produced by changes in head position. It originates in the semicircular ear canals and is thought to be caused by tiny deposits settling on small sensitive hairs. These hairs help you to determine head movement and position. When the debris adheres to the hairs it provides overstimulation, which sends incorrect information to the brain. The brain thinks even small head movements are substantial, resulting in sensations of dizziness and vertigo which usually last less than a minute. Because this disorder can mimic other more serious diseases, benign positional vertigo should be diagnosed and treated by your doctor or physical therapist.
Epley Maneuver
Begin the Epley maneuver sitting comfortably on your bed. Turn your head to 45 degrees in the direction that causes your vertigo. Lay your body back on the bed while maintaining the head position. Hold this position for three to four minutes. Turn your head in the opposite direction to a 45-degree angle and hold for three to four minutes. Roll into a side-lying position in the direction you are facing, maintaining the 45-degree head rotation. Hold for three to four minutes. Return to sitting for one minute. The entire procedure can be repeated up to three times.
Semont Maneuver
To perform the Semont maneuver, begin in a seated position on your bed. Turn your head 45 degrees in the opposite direction that causes your vertigo. Quickly move the body toward the opposite direction and assume a side-lying position. You should be looking up toward the ceiling. Hold this position for three to four minutes. Swiftly move through sitting and into side-lying on the other side while maintaining head position. You should be looking down toward the bed. Hold this position for three to four minutes. Slowly resume a sitting position.
Brandt-Daroff Exercises
Brandt-Daroff exercises are begun in sitting on your sofa or on the edge of your bed. Swiftly lean to the side that causes the vertigo and assume a side-lying position. Hold this position until the vertigo passes or for 30 seconds, Susan J. Herdman recommends in the 2007 book "Vestibular Rehabilitation, 3rd Edition." Return to sitting. If you feel a return of the vertigo, remain sitting until it passes or for 30 seconds. Quickly lean to the opposite side and assume the side-lying position. Hold until the vertigo passes or for 30 seconds. Repeat this side-to-side motion for 20 repetitions, twice daily.
Treatment Outcomes
Performing any of the above exercises may elicit your dizziness and vertigo symptoms. Some people have such severe symptoms that they experience nausea and vomiting. There is good news, however. Research has found that the majority of people treated with these exercises achieve complete symptom relief, researchers S.H. Lee and J.S. Kim wrote in a 2010 article in the "Journal of Clinical Neurology."
References
- "Otolaryngology-Head and Neck Surgery"; Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo; N. Bhattacharyya, R.F. Baugh, L. Orvidas, et.al.; 2008
- "Vestibular Rehabilitation, 3rd Edition"; Susan J. Herdman; 2007
- "Archives of Otolaryngology-Head and Neck Surgery"; Efficacy of the Semont Maneuver in Benign Paroxysmal Positional Vertigo; E. Levrat, G. van Melle, P. Monnier, et.al.; 2003
- "Journal of Clinical Neurology"; Benign Paroxysmal Positional Vertigo; S.H. Lee, J.S. Kim; 2010
