Epley maneuver is one of the most successful repositioning maneuvers for the posterior canal BPPV. Here, shown for the right side
Specific corrective maneuvers have been designed for each subtype of BPPV.
Assuming the correct diagnosis, 80% of patients can be cured during the initial attempt. The success rate increases to 95% when the maneuver is repeated during the follow-up visit.
“Witnessing the complete disappearance of dizziness in a patient who was previously barely able to move is almost miraculous. It is one of the most satisfying aspects of my profession to correctly diagnose and successfully treat a disease that is challenging to learn and master.”
Unfortunately, in healthcare institutions where doctors are overwhelmed by many patients, there is often insufficient time dedicated to balance disorder patients. Proper evaluation and treatment for these patients necessitate spending around half an hour per patient. This includes confirming that vertigo/dizziness originates from the inner ear, understanding its type, duration, character, and triggers, performing specific diagnostic maneuvers, interpreting recordings, and finally applying corrective maneuvers.
As I consistently emphasize to my patients, BPPV is a recurrent condition with 15% recurrence within the first year and 50% by the fifth year. Fortunately, recurrences can also be treated with the same high success rates.
“Regrettably, I frequently encounter patients to whom vestibular suppressants with severe side effects are prescribed without even conducting a proper vestibular examination. Then, a problem that could be resolved in a single visit may persist for months.”