Anne Marie -Benign Paroxysmal Positional Vertigo

[Bhavani <http://www.juno.com/~bhavaniowl>]

Hi everyone,  

Thank you so much for your love and prayers.  I'm very grateful, and
here's the essence of my appointment with the audiologist today.

Her testings lasted over 2 hrs and ultimately she was confident in
stating that I was misdiagnosed with Viral Labyrinthitis 2 yrs ago.  In
her opinion I do have vertigo, but NOT Viral Labyrinthitis.  Rather I'm
now diagnosed with Benign Paroxysmal Positional Vertigo which will be
treated through her office with physical therapy once or twice a week. 
Her belief is that my incorporating very specific balancing exercises
into my daily routine is mandatory for the rest of my life.  She also
feels that I lost 2 yrs of proper physical therapy because of the initial
misdiagnosis, so that now it will take extra time for my body to catch up
on correcting the compensations made  within the past 2 yrs before it can
relearn a healthy balance.

I was also told that this type of vertigo can't be helped through drugs
so that if physical rehabilitation fails to work, surgery would be a last
resort.  By the  way, various balancing exercises such as Tai Chi or Yoga
were suggested too, on a long-term basis, and so following PT for a
period of time, I intend to give Tai Chi a try.   

What follows is a brief definition along with some suggested forms of
treatment, and for now this is all I know.  The best news is there exists
potential treatments, and for that I'm immensely grateful.    :)

Thanks sooo much again everyone.  I felt very loved and supported today,
and I hold each of you with gratitude in my heart.  

Blessings to all,   
Anne Marie

Right below is one of the tests that the audiologist did yesterday.  I
just happened to come across it online just now.  Was Robert given this
test too?________

Electronystagmography (ENG) or videonystagmography (VNG). The purpose of
this test is to detect abnormal eye movement. ENG (performed with
electrodes) or VNG (performed with small cameras) can help determine if
dizziness is due to inner ear disease by measuring involuntary eye
movements while your head is placed in different positions or your
balance organs are stimulated with water or air. Other tests can assess
your ability to maintain an upright position under easy and difficult
conditions. 

Definition
By Mayo Clinic staff 

Vertigo is the sudden sensation that you are unsteady or that you or your
surroundings are moving. You may feel like you're spinning around on a
merry-go-round or that your head is spinning inside. Benign paroxysmal
positional vertigo (BPPV) is one of the most common disorders that can
cause vertigo. 

Benign paroxysmal positional vertigo is characterized by brief episodes
of mild to intense dizziness associated with specific changes in the
position of your head. It most commonly occurs when you move your head in
a certain direction, lie down from an upright position, turn over in bed
or sit up in the morning. Moving your head to look up or look down also
can bring about symptoms of benign paroxysmal positional vertigo. You may
also feel out of balance when standing or walking. 

Treatments for - 
Benign Paroxysmal Positional Vertigo
The treatment of choice for this condition is the Epley canalith
repositional maneuver which is effective in approximately 80% of
patients[2]. The treatment employs gravity to move the calcium build-up
that causes the condition.[3] The particle repositioning maneuver
(Epley's maneuver) can be performed during a clinic visit by specially
trained otolaryngologists, neurologists, chiropractors, physical
therapists, or audiologists. The maneuver is relatively simple but few
general health practitioners know how to perform it. A method known as
the Semont maneuver[4] in which patients themselves are able to achieve
canalith repositioning has been shown to be effective.[5]

Devices such as a head over heels "rotational chair" are available at
some tertiary care centers [6] Home devices, like the DizzyFIX, are also
available for the treatment of BPPV and vertigo. [7][8]

The Epley maneuver (particle repositioning) does not address the actual
presence of the particles (otoconia), rather it changes their location.
The maneuver moves these particles from areas in the inner ear which
cause symptoms, such as vertigo, and repositions them into areas where
they do not cause these problems.

Meclizine is a commonly prescribed medication, but is ultimately
ineffective for this condition, other than masking the dizziness. Other
sedative medications help mask the symptoms associated with BPPV but do
not affect the disease process or resolution rate. 
Betahistine (trade name Serc) is available in some countries and is
commonly prescribed but again it is likely ineffective. Particle
repositioning remains the current gold standard treatment for most cases
of BPPV.

Surgical treatments, such as a semi-circular canal occlusion, do exist
for BPPV but carry the same risk as any neurosurgical procedure. Surgery
is reserved for severe and persistent cases which fail particle
repositioning and medical therapy.

Although BPPV accounts for the overwhelming majority of cases of
positional vertigo, there are other possibilities, one in particular
being -  Vertebral artery compression.