Can I prevent BPPV?

We often are asked if there is anything a person can do to prevent BPPV from coming back. To date there is no evidence that doing a maneuver will prevent all recurrences. A recent study in 2008 (Daily exercise does not prevent recurrence of benign paroxysmal positional vertigo. Otology and Neurotology) demonstrated this fact but lacked, in my opinion, sufficient numbers of patients to end the debate. It certainly would intuitively seem to make sense that a prophylactic maneuver would prevent, at least some, recurrences.

There are, however, factors which make dizziness worse. Age, head trauma and inner ear infections are risk factors for BPPV. Stress, depression, caffeine and alcohol make the experience of dizziness worse also. Any inner ear condition like Menieres disease has also been associated with an increased risk of BPPV.

So, what can be done? Reduce stress where possible and avoid medications or drugs to reduce possible side effects. Prophylactic maneuvers have thus far not demonstrated efficacy but they don’t hurt either. I’d be interested to hear if anyone is having any luck at prevention themselves.

As usual – discuss all medical issues with your own physician.

16 Responses

  1. Leah
    |

    I’ve had an episode of BPPV 2015 where it was undiagnosed for 12mnths which left me with a balance disorder, I had a relapse of BPPV in Oct this yr but had my crystals realigned but still once again very off balance, specialist said I also have a rare kind of migraine where u get the off balance thing but not the migraine itself, it took me 9 mnths to get bck to a liveable state in 2015 , do u have any suggestions wld travel sickness drugs help.

  2. Edward Harris
    |

    I have a pretty serious case of BPPV. It rarely happens more than once per year and for some strange reason always tends to start in the spring, around the month of May when it strikes. Sometimes it may skip a year, or two! But it always returns sooner or later. I had a bout this year that was worse than any other attack, starting in May and remaining until September. Just before it faded away (thank God I’m 100% fine now) it almost killed me. I had been dizzy, but had an bad attack, severe dizziness, room moving, and throwing up every 15 minutes for 26 straight hours. In those 26 hours my weight dropped from 205lbs to 189lbs. The whole experience was a hell that I would not wish on my worst enemy. I felt like it came close to taking me out. My big question now is can it be prevented in the future!! I am 61 years old and barely survived my last attack. Were I 70 or 75 I would never have made it, and those days, God willing, may be coming. Naturally I have done my homework on the BIG TIME. I have no answer, but do have some worthy suggestions that I know help. First, AVOID STRESS. I have found this to be the single biggest contributor to a new Vertigo attack! Also a lack of stress helps reduce symptoms quicker. Get plenty of sleep. The more sleep the better and preferably when you feel an attack coming BEFORE it fully hits. Definitely avoid caffeine and alcohol! I love a cup of coffee per day, but you are better off avoiding those things 100%. Pepto Bismol helps me better than any other thing with reducing nausea, and helping to keep fluids down. Avoid television and video games during an attack. Though I am a big believer in nutrition, I have not found any supplements that help. However I do wonder about the possibility of L-lisine as a possible preventative supplement simply because L-lisine is a strong combatant against the herpes virus, and it is theorized that a form of the herpes virus may possibly be behind some of the things that may cause vertigo. This is all theory on my part and unproven. Personally, I have not found that any of the exercises recommended help me in the least. They only make me sicker. Sorry. That is about all I have to share. I wish everyone who suffers with the my greatest sympathy.

  3. Suzan Gittens
    |

    I had a BPPV episode at the same time I had simple dizziness due to Candida overgrowth in one Eustachian tube. I had used Daktarin oral jell to clear up the Candida but then experienced the BPPV episode (cured with Epley maneuver). This makes me think that chronic yeast overgrowth may be a cause of BPPV. If so, perhaps the particle in the inner ear that causes the spinning symptoms may be live or even dead Candida? “K”, your experience of “an ear infection with pressure pain, ringing, and some jaw pain on the left side” is similar to the symptoms of a Candida infection in the Eustachian tube. Candida can cause a host of problems throughout the body so there is certainly no harm in addressing it as a possible root cause of BPPV. The cure includes probiotics and shifting the diet away from starches and sugars.

  4. Felicia Pillitteri
    |

    I got diagnosed with bppv by 2 doctors in thr last year. I’m triggering it and its debilitating because i haven’t been able to return to work nor drive. Any movement brings on dizziness and had many maneuvers including the last one done was Epley. Since Epley, I get daily headaches, dizziness, and blurred vision. Does anyone have these symptoms?

  5. Joe Shelton,
    |

    I found another maneuver that is better for me than the Epley. Not sure I can explain it, so it may be best to use YouTube and search for “Vertigo maneuver by Dr. Carol Foster”. Basically you are on your knees, begin by leaning your head back slightly for a few seconds (5 -10), raise your head back up briefly. While still on your knees, facing straight ahead bend over, and bracing yourself with the palms of your hands touch the top of your head on the floor, pull your chin in and turn your head to the right and hold that position for 30 seconds. Turn your head back to normal position, still facing your knees and then slowly raise your body to a lateral position with the floor, bracing the palm of your hands, and turn your head again to the right and hold for 30 seconds. Turn you head back to a normal position and raise up at the waist while still on your knees. Your finished and can stand up. I will say if you are an extreme case have a spotter handy to ensure you don’t fall over during the procedures, and of course be safely away from hard furnishings etc…

    Helped me immediately, and I now incorporate into my daily events when rising for the day…

    Be blessed, be healthy!

  6. Joe Shelton
    |

    I found another maneuver that is better for me than the Epley. Not sure I can explain it, so it may be best to use YouTub and search for “Vertigo maneuver by Dr. Carol Foster”. Basically you are on your knees, begin by leaning your head back slightly for a few seconds (5 -10), raise your head back up briefly. While still on your knees, facing straight ahead bend over, and bracing yourself with the palms of your hands touch the top of your head on the floor, pull your chin in and turn your head to the right and hold that position for 30 seconds. Turn your head back to normal position, still facing your knees and then slowly raise your body to a lateral position with the floor, bracing the palm of your hands, and turn your head again to the right and hold for 30 seconds. Turn you head back to a normal position and raise up at the waist while still on your knees. Your finished and can stand up. I will say if you are an extreme case have a spotter handy to ensure you don’t fall over during the procedures, and of course be safely away from hard furnishings etc…

    Helped me immediately, and I now incorporate into my daily events when rising for the day…

    Be blessed, be healthy!

  7. Bonnie
    |

    I ended up in the ER a year ago with my first horrific episode of Vertigo (BPPV). I remained very ill for 7 days. I’ve since learned to use the Epley Maneuver. I get dizzy when I write on the white board at school (I am a teacher), I can’t look up, I can’t sleep on my right side or my back. When I go to the dentist and am put back in the chair – the room spins. When I go to the chiropractor I cannot lay on my back on the table. I cannot lay back in the chair at the beauty parlor to have my head shampooed. I cannot lay on my back to have a massage. I cannot lay on my back on the exam table for a breast exam or pelvic exam. I am scheduled to have an MRI in July. I am very worried about having to lay on my back inside that tube for a long period of time. I assume I will have a horrible Vertigo episode which may include vomiting. How can I have an MRI of my head if I cannot lay in the machine????

  8. dan
    |

    I turned my head to left the other day and got vertigo that lasted 20 minutes since then ive had 4 episodes is this bppv

  9. dan
    |

    Turned my head to left the other day and got vertigo that lasted about 20 minutes since then ive had 4 episodes after head movement could this be bppv.

  10. Carol
    |

    I get BPPV after flying. It has happened 3 times now. I am a healthy 44 year old women. Could flying cause my BPPV?

  11. Bob evans
    |

    Daily epley sessions have reduced the frequency and intensity of vertigo episodes. At least for me.

  12. Clearwater Clinical
    |

    Great question. There is hope! No irrigating the ear will not help with BPPV. No the water cannot get anywhere close to where the crystals are. However, doing an epley maneuver (particle repositioning maneuver) on a daily basis may help prevent the crystals from achieving critical mass. This is an unproven strategy but it only makes sense. I would love to hear how you make out. If you need help doing the epley at home you can use home treatment devices like DizzyfIX. Stay in touch with how it works out, keep a journal of when it happens and then start daily preventative maneuvers and keep the journal up to date so you can compare before and after treatments. Best of luck.

  13. Casey
    |

    I was diagnosed with BPPV two years ago. With some episodes I have a little bit of advanced notice… Other times no warning at all.

    Since this is said to be caused by calcium crystals lodging on hairs in the inner ear… My question is…

    Would irrigating the ear dislodge the crystal(s)? Can the water go in far enough to reach the crystals?

  14. Ron
    |

    I am a male athlete and having the exact symptoms and problems you are. I notice your post is a couple years old, can you give me a status update on what had happened to you.
    Thanks

  15. Clearwater Clinical
    |

    Thanks for posting your story. Obviously you have a complicated history. I can only comment in generalities since you should speak with your own doctor about your healthcare needs. With that said, the “off” feeling you describe is not uncommon after successfully treating an episode of BPPV. Fortunately is lasts only 1-2 weeks while you get used to the post-treatment state. You are also correct in that BPPV is recurrent and may come back again in up to 50% of people.

    With respect to the question of prevention – there is very little evidence that you can prevent it from coming back. However, it would make sense that it could be prevented given what is known about it being due to crystals building up in the posterior canal. We believe that BPPV is due to a critical volume of crystals collecting in the posterior canal. If you empty these out daily I would imagine that you would never get a full-on recurrence, although you might get the off balance feeling.

    As above I always suggest you speak with your own doctor about specific questions. In answer to, ‘Can I prevent BPPV?’, I would suggest yes – by daily Epley maneuvers, however, there is no scientific evidence to that effect to date. If you prefer there are assistive devices to ensure you do a correct maneuver. I do not suggest post procedural precautions (sleeping upright etc) as they appear in effective when all current literature is reviewed – there is a blog post to that effect elsewhere.

    Thanks again for your comments.

  16. k
    |

    I am a young, healthy ,and fit competitive kayaker. I am constantly performing athletic maneuvers, upside down in water and I rely heavily on my balance. I wear earplugs, but have suffered the occasional ear infection over the years. Nothing horrendous. Several months ago, I had a couple of awful but quick spinning episodes following a 4 foot fall onto hard ground on my left side. I noticed it was “weird” to turn my head quickly back and forth, but figured it was a sore neck. I also felt “OFF” (I described it as drunk), and had mild nausea. I saw my doctor twice and he wasn’t concerned. My eye movements were normal, and my blood work was perfect. Because I felt “drunk” after eating, doc gave me glucose tolerance tests. Not diabetic. “Stay away for 2 years” he told me. I still felt weird and unsatisfied. Holistic doctors suggested that I might have an overgrowth of yeast (Candida) from eating a high sugar/bread diet and taking a course of Cipro for a UTI. Maybe the good flora in my gut was gone and I was experiencing foggy brain symptoms from ‘leaky gut syndrome’. It was also suggested I had hormone imbalances causing nausea. Hmmm. I took probiotics, changed birth control pills, and changed my diet. I began losing weight which worried me but I leaned out and felt somewhat better. I eventually felt closer to normal and resumed my activities… but always remained the difficulty turning my head quickly. 6 Months later, I got an ear infection with pressure pain, ringing, and some jaw pain on the left side. After treatment for the ear with drops, the jaw pain remained. I mentioned it to my dentist, who decided I had TMJ and made me a mouth guard. I began wearing it….Now suddenly, and without warning, I just had a horrible attack of obvious vertigo and vomiting that led into dehydration and a seizure. I visited the ER… All scans normal. I now know I have vertigo… specifically BPPV. Doctors told me nystagmus indicated my left ear was affected. Hmm…the side I fell on 8 months ago?! And the side I just had an infection in?! They gave me drugs and told me to lay low. I don’t like that much, so I looked it up online and found the Epley Maneuver, did it and got instant relief from the spinning and nausea. Now I am back to the “OFF” feeling… drunk… hard to do much. Everything I read says vertigo comes back over and over. Great. It also says to stay still and sleep on the opposite side after the Epley. I’m doing that, but I’m anxious to exercise, do yoga, and get out. I’m supposed to fly in 3 days for a kayaking trip. Can I do that? I’m just not sure what to expect as an athlete… I will do any physical therapy I can to get this resolved, I just want my life back! Suggestions for an athlete with BPPV? Hoping its not Labyrinthitis because of the ear or TMJ thing. I do have allergies and minor sinus problems but not right now. Thoughts? Thanks!

Leave a Reply