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.

7 Responses

  1. 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?

  2. Bob evans

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

  3. 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.

  4. 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?

  5. 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.

  6. 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.

  7. 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!

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