Dr. Mehak Agarwal
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had an episode of BPPV this morning. I had a couple earlier this year and I am confused as to which is the bad ear so I can do the proper procedure. It happens in this scenario: I lay on my left side and switch to my right. Vertigo starts up when I lay on my right side but only after I have been laying on my left. In fact, I could not get it to do it by turning my head and laying back on either side independently. By what I described, can you determine which is the bad ear? I did the Eppley starting on the left side but got nothing. When I shifted to the right it started for 20 seconds. I aborted not wanting to go in the wrong direction.
Hi,
Welcome to icliniq.com.
With details of your history, it is difficult to say which side it is on but since with Epley, you get vertigo when you do on the right side, it seems to be more on the right side. It does not matter which ear it is in or if it is bilateral. The treatment is the same. The side matters if we try to cure by maneuver. Are you taking any medicine for vertigo like Betahistine, etc? Precautions: You should restrict salt in the diet. Also, there is some balancing exercise that helps in the long term. The neck exercise should be avoided if you have a cervical problem. Also, let me know if you have other complaints like nausea and fullness in the ears.
Patient's Query
Thank you, doctor,
I was interested in doing a maneuver at home today to move the crystal out. I am traveling tomorrow afternoon. So, I would like to fix this first. That is why I was trying to figure out the correct side. No, Betahistamine. I have had sinus issues in the cheeks, eyes, and nose for the last few years, especially. I have some mild dizziness and slight nausea today. Just feel a bit off.
Hi,
Welcome back to icliniq.com.
I would advise you not to do maneuvres yourself. It is done by a doctor and depends which canal is involved. Epley is done if the posterior canal is involved (which is most commonly involved). Clinical diagnosis can be made by Dix hallpike maneuver and otherwise, electronystagmography can be done. In your case, if your concern is immediate relief from dizziness kindly take Betahistine 16 mg twice daily and Prochlorperazine 5 mg twice and if you want to rule out other diagnoses, then more investigations are required. Do revert back if you have any other query.
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Otolaryngology (E.N.T)
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