Can I make my BPPV worse with failed treatment?

I was recently asked: “Has any BPPV patient managed to make their condition worse with a bungled treatment?”

The answer is not particularly straight forward.  Any treatment of BPPV has the potential to convert to something called Horizontal canal BPPV. The most common type of BPPV is Posterior canal BPPV. 

The estimated rate of this complication of treatment of BPPV is about 5%. You run this risk every time you roll over in bed but in particular during a repositioning maneuver. The good news is that horizontal BPPV, while more intense (if you can believe that) it is often short lived and goes away by itself in nearly all cases.

Home treatment of BPPV has no higher risk of this conversion than office maneuvers. The only benefit of the in office treatment is that there is someone there to comfort you.  I also suggest that you never do the maneuver alone even if you are doing it at home. You just never know if you need help if you vomit or feel nauseous.

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