What are the types of BPPV treatment?

There are three treatments of BPPV that are usually performed in the doctor’s office.

All treatments are very effective, with roughly an 80% cure rate.

EPLEY MANEUVER

SEMONT MANEUVER

BRANDT-DAROFF 

If your doctor is unfamiliar with these treatments, you can find a list of clinicians who have indicated that they are familiar with the maneuver from the Vestibular Disorders Association.

No active BPPV treatment (wait/see):

If you decide to wait it out, certain modifications in your daily activities may be necessary to cope with your dizziness. Use two or more pillows at night. Avoid sleeping on the “bad” side. In the morning, get up slowly and sit on the edge of the bed for a minute.

Avoid bending down to pick up things, and extending the head, such as to get something out of a cabinet. Be careful when at the dentist’s office, the beauty parlor when lying back having ones hair washed, when participating in sports activities and when you are lying flat on your back.

Symptoms tend to wax and wane. Motion sickness medications are sometimes helpful in controlling the nausea associated with BPPV but are otherwise rarely beneficial.

BPPV has often been described as “self-limiting” because symptoms often subside or disappear within 2 months of onset. BPPV is not life-threatening. One can certainly opt to just wait it out.


BPPV Treatment and Drugs

The inner ear and canalith repositioning

To help relieve benign paroxysmal positional vertigo (BPPV), your doctor, audiologist or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.

Canalith repositioning

Performed in your doctor’s office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head.

The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny bag-like open area (vestibule) that houses one of the otolith organs (utricle) in your ear where these particles don’t cause trouble and are more easily resorbed.

Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.

After the procedure, you must avoid lying flat or placing the treated ear below shoulder level for the rest of that day. For the first night following the procedure, elevate your head on a few pillows when you sleep.

This allows time for the particles floating in your labyrinth to settle into your vestibule and be resorbed by the fluids in your inner ear.

On the morning after your in-office procedure, your restrictions will be lifted and you’ll begin self-care as directed by your doctor.

Your doctor likely will have taught you how to perform the canalith repositioning procedure on yourself so that you can do it at home before returning to the office for a recheck.

Surgical alternative

In very rare situations in which the canalith repositioning procedure isn’t effective as BPPV treatment, your doctor may recommend a surgical procedure in which a bone plug is used to block the portion of your inner ear that’s causing dizziness.

The plug prevents the semicircular canal in your ear from being able to respond to particle movements or head movements in general.

This success rate for canal plugging surgery is greater than 90 percent.