Introduction
Benign paroxysmal positional vertigo is a very common form of vertigo, which occurs particularly with jerky rotational movements. It is caused by small crystals that get stuck in the human auditory canals, thus disturbing the flow of the endolymph located there and leading to paresthesia. We perceive these sensations as dizziness.
Exercises
There are several very simple exercises with a high success rate, with which the very unpleasant dizziness can be treated efficiently and quickly. Surely your family doctor or neurologist has already informed you about one of these exercises. However, since these have to be performed according to an exactly given pattern in order to be successful, they are described here once again in detail. Among the two best known are the so-called “liberation maneuvers” according to Epley and Semont. It should be noted that sudden nausea can occur during these exercises, so appropriate precautions should be taken.
Epley maneuver
The patient sits upright on the couch. Now he turns his head by 45 degrees so that the examiner standing in front of him looks at the healthy ear. For reasons of comprehensibility, it is assumed in these and the following examples that the right ear is the affected one.
The patient would now look to the right so that the left, healthy ear is facing the examiner. Now the patient would lie flat on his back and let his head hang over the back of the couch or, if you are at home, over the couch in a slightly overstretched position. The patient now remains in this position, always with the head turned to the “sick” side, until the positioning vertigo and eye tremor have disappeared.
Now the head is turned 90 degrees from its 45 degree right position to a 45 degree left position. Again, wait at least one minute until the vertigo has subsided. Now the entire body follows the head so that the patient lies on the left side of the couch or couch.
The head is turned a little further towards the floor. In this position the patient must again stay for one minute. If dizziness and eye tremors have subsided, the patient will sit up abruptly as if he were sitting “normally” on the couch.
This may cause severe nausea, so the eyes should be closed during this last step. The Epley maneuver is now complete, the dizziness should have subsided. If this maneuver is not successful, it can be repeated two or three more times. If there is no further improvement of the symptoms, the cause may be different, or the exercise may not be suitable.
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