By the word “dizziness,” ordinary people mean a lot of discomfort, so the doctor will ask a bunch of leading questions. First, let's try to understand what exactly is bothering you.
1. “Carousel” - is the room or your body spinning and spinning around you?
2. “We were riding in a boat” - unsteadiness and instability when standing or walking?
3. “Holy shit” - a feeling that you are about to lose consciousness, some kind of vague experience (“my head is empty”, “I can’t concentrate”)?
Then the doctor will ask whether these sensations were paroxysmal or constant, how long ago they appeared and what provokes them (for example, a change in body position, turning from side to side in bed, a stuffy room or a long period of time). vertical position), what medications you take, whether you smoke, how much caffeine and alcohol you consume, whether you have tinnitus, and whether you have had a traumatic brain injury. ( Regarding this, I advise you to write down complaints in advance)
In addition to the general ones, which are familiar to everyone who has ever been examined by a neurologist, the doctor will do a couple of tests, which usually cause terrible bewilderment in patients, so I will go into more detail.
1."Do you want to kill me?"- test with a horizontal head impulse test (in English literature - horizontal head impulse test, head thrust test) The patient fixes his gaze on the bridge of the doctor’s nose, the patient’s neck is relaxed. The doctor sharply turns the patient's head to the side and observes the movement of the eyes during the turn.
2. "I'm shocked!" - Head-shake test. The patient lowers his head forward by 30°. The doctor turns (shakes) the patient's head from side to side with an amplitude of 30° and a frequency of 2 Hz for 20 seconds.
3. "peek-a-boo"- the doctor alternately covers one or the other eye of the patient with his palm.
Actually a sample a lot of. But for some reason, patients tolerate the sample (test) much more calmly Dix-Hallpike. It is carried out as follows: the patient is seated on the couch in such a way that when lying down, the head hangs freely from the edge of the couch. The patient's head is turned 45° towards the supposed “sore ear”. The subject's gaze is focused on the bridge of the doctor's nose. He himself is abruptly placed on his back, while his head hangs down (thrown back 30°).
Impressive?
And now - the most boring part.
The doctor examined me, examined me for something, prescribed something and recommended... physical education.
1. Brandt-Daroff method. It is usually recommended for patients to use on their own.
According to this technique, the patient is recommended to perform exercises three times a day, 5 times in both directions in one session. If dizziness occurs at least once in the morning in any position, the exercises are repeated during the day and evening. To perform the technique, the patient must, after waking up, sit in the center of the bed with his legs hanging down. Then he lies on either side, with his head turned upward by 45° (i.e., forehead up), and remains in this position for 30 seconds (or until the dizziness stops). After this, the patient returns to the original sitting position, in which he remains for 30 seconds, after which he quickly lies down on the opposite side, turning his head upward by 45 (again, forehead up)°. After 30 s, he returns to his original sitting position. In the morning, the patient performs five repeated bends in both directions. If dizziness occurs at least once in any position, bending should be repeated during the day and evening.
The duration of such therapy is selected individually. The effectiveness of this technique for relieving benign paroxysmal positional vertigo is about 60%. You can complete the exercises if the positional vertigo that occurs during the Brandt-Daroff exercises does not recur within 2-3 days.
Other treatment maneuvers require the direct participation of the attending physician. Their effectiveness can reach 95%, but significant dizziness with nausea and vomiting is possible, so in patients with heart disease vascular system maneuvers are performed with caution and preliminary administration of betahistine (24 mg once 1 hour before performing the maneuver).
2. Semont maneuver. Performed with the help of a doctor or independently. Starting position: sitting on the couch, legs hanging down. While sitting, the patient turns his head in a horizontal plane 45° to the healthy side. Then, fixing the head with the hands, the patient is placed on his side, on the affected side. He remains in this position until the dizziness stops. Next, the doctor, quickly moving his center of gravity and continuing to fix the patient’s head in the same plane, places the patient on the other side through the “sitting” position without changing the position of the patient’s head (i.e., forehead down). The patient remains in this position until the dizziness completely disappears. Next, without changing the position of the patient’s head, he is seated on the couch. If necessary, you can repeat the maneuver.
3. Epley maneuver. It is advisable to have it performed by a doctor. Its peculiarity is a clear trajectory, slow movement from one position to another. The patient's starting position is sitting along the couch. First, the patient's head is turned 45° towards the pathology. The doctor fixes the patient's head in this position. Next, the patient is placed on his back, his head tilted back 45° (you can use a pillow under the shoulder blades). The next turn of the fixed head is in the opposite direction in the same position on the couch. Then the patient is placed on his side, and his head is turned with the healthy ear down. Next, the patient sits down, the head is tilted and turned towards the pathology, after which it is returned to its usual position - looking forward. The patient’s stay in each position is determined individually, depending on the severity of the vestibulo-ocular reflex. Many specialists use additional means, which increases the effectiveness of treatment. As a rule, 2-4 maneuvers during one treatment session are enough to completely relieve benign positional vertigo. (video -)
4. Lempert maneuver It is advisable to have it performed by a doctor. The patient's starting position is sitting along the couch. The doctor fixes the patient's head during the entire maneuver. The head is turned 45° and horizontally towards the pathology. Then the patient is placed on his back, successively turning his head in the opposite direction, and after that - on his healthy side, the head, accordingly, is turned with his healthy ear downwards. Next, the patient’s body is turned in the same direction and placed on his stomach; the head is given a position with the nose down; As you turn, the head turns further. Following this, the patient is placed on the opposite side; head - sore ear downwards; The patient is seated on the couch through the healthy side. The maneuver can be repeated.
After performing the exercises, it is important for the patient to comply with the regime of limiting bending, and on the first day you need to sleep with the head of the bed raised by 45-60° (for this you can use several pillows).
Exercises are needed if you have been diagnosed with otolithiasis, benign positional or chronic subjective vertigo!
About Nicergolin - they lied, of course)))))
Benign positional paroxysmal vertigo (BPPV) is a lesion of the inner ear, which manifests itself as paroxysmal occurrence of severe dizziness in certain positions of the head. The main method of treating BPPV is to carry out the so-called rehabilitation maneuver - a special complex .
It should be noted that independent studies are possible only after a doctor has reliably diagnosed BPPV, since in cases of tumor or ischemic brain damage, as well as a high probability of compression of the vertebral artery, self-medication can complicate the provision of timely professional medical care and worsen the patient’s condition.
The most adapted for the patient to perform independently are the Brandt-Daroff and Epley-Simon gymnastics.
1. In the morning, after sleep, sit on the bed with your back straight (Position 1)
2. Then you need to lie on your left (right) side with your head turned up at 45° (to maintain the correct angle, it is convenient to imagine the person standing next to you at a distance of 1.5 meters and keep your gaze on his face) - Position 2
3. Stay in this position for 30 seconds or until the dizziness disappears
4. Return to the starting position while sitting on the bed
5. Then you need to lie on the other side with your head turned up 45° - Position 2
6. Stay in this position for 30 seconds
7. Return to the starting position sitting on the bed (Position 1)
8. Repeat the described exercise 5 times
If dizziness does not occur during the exercise, it is advisable to perform it only the next morning. If dizziness occurs at least once in any position, then you need to perform the exercises at least two more times: in the afternoon and in the evening.
1. Sit on the bed with your back straight (Position 1)
2. Turning your head towards the affected labyrinth, stay in this position for 30 seconds (Position 2)
3. Lie on the bed with your head thrown back 45°, stay in this position for 30 seconds (Position 3)
4. Turn your head in the opposite direction, stay in this position for 30 seconds (Position 4)
5. Turn on your side with your head turned with your healthy ear down, stay in this position for 30 seconds (Position 5)
6. Return to a sitting position on the bed with your legs down
The correct execution of the complex is shown in the following video clip:
It should be noted that independent implementation of the Epley-Simon complex is difficult at first due to the patient’s ignorance of the side of the diseased labyrinth; in addition, the opposite side may also be involved in the pathological process. In this regard, it is highly advisable to only continue the classes started by the doctor, and not self-medicate.
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Benign paroxysmal positional vertigo (BPPV) is a fairly common pathology. One way effective therapy To reduce the symptoms of the disease is the Epley maneuver.
Symptoms
BPPV develops more often in women. Most probable cause The occurrence of the disease is considered to be the deposition of calcium salts (otoliths) in the canal of the inner ear. Head movements (tilts, turns, tilts) provoke short-term attacks of dizziness. Between episodes, the patient may experience nausea, hesitation blood pressure, loss of balance, impaired thermoregulation. Regular intense attacks can cause such great inconvenience that the question of what to do with dizziness is in the first place for the patient. With timely treatment, BPPV does not cause lasting harm to health; the benign nature of the disease implies a decrease in the severity of episodes.
Diagnostics
The diagnosis of BPPV can be made by a doctor based on the patient's medical history. Additional neurological diagnostic methods are the Dix-Hallpike test and the rotation test.
Treatment
The choice of treatment for this disease depends on the type of damaged canal. IN modern medicine To eliminate symptoms, changing the position of the otoliths is also used. Special therapeutic techniques will help alleviate the condition of BPPV. Recommended physical therapy doctor in benign paroxysmal positional vertigo, it reduces the severity of attacks. Treatment should take into account the location of the otolith crystal in the semicircular tubules of the inner ear. The positional Epley maneuver is the most studied method and controls seizures in posterior and lateral pathologies. The essence of treatment is to change the position of the otoliths. The fixed crystal dissolves, thereby contributing to the disappearance of symptoms.
Maneuver technique
Back in 1992, the Epley maneuver was proposed. When used, calcium carbonate crystals are removed from the semicircular tubules by gravity. The procedure is often accompanied by increased autonomic symptoms, which is explained by the forced movement of otolith fragments. It is important to follow the exact technique of performing the Epley exercise.
- The patient sits straight on the couch, turning his head towards the affected ear by 45˚.
- Then, with the head still rotated, the patient is carefully placed so that the head is slightly thrown back. He remains in this position for a certain period of time - 20-60 seconds.
- Then the head is turned 90˚ to the healthy side.
- After a period of time, the patient’s body and head in a fixed position are turned in the same direction by another 90˚. His face is directed downwards. He remains in this position for certain seconds.
- The patient slowly sits down in the starting position.
During the positional maneuver, you should feel dizzy. Suggested exercises to achieve full effect must be performed multiple times during the procedure. The number of repetitions is regulated by personal feelings: as soon as the dizziness stops, the session ends. After the procedure is completed, you should rest for about 10 minutes. It is important not to make sudden movements of the head so that the contents of the inner ear do not shift. Regular exercise therapy will gradually help dissolve calcium salts. It is quite possible to reduce the symptoms of this disease without the use of medicines.
The Epley maneuver is also called a canal realignment procedure. The correct execution at first should be monitored by a doctor. He must assess whether the patient will be able to do therapeutic exercises on one's own. The health risk, according to experts, with incorrect technique is minimal, but a decrease in the expected effectiveness for the treatment of BPPV is likely.
If you don't know what to do if you experience dizziness regularly, you should consult a doctor. If the diagnosis of benign paroxysmal positional vertigo is confirmed, it is necessary to adhere to the prescribed treatment. This disease is quite common and responds well to treatment.
Benign paroxysmal positional vertigo (BPPV) is pathological condition vestibular origin, which is characterized by paroxysmal manifestations of dizziness.
This state is provoked by changes in spatial position human body.
The differences between this type of dizziness are the relative ease of treatment and the possibility of self-improvement.
Etiological factors in the development of functional dizziness (causes)
Benign paroxysmal positional vertigo (BPPV), a very complex condition in etiology, in some cases it is not possible to establish the true cause of the disease.
To the most common reasons DPP include:
- traumatic injuries of the skull and concussions;
- inflammatory processes in the labyrinth of the inner ear;
- undergone surgical interventions in the head area.
Features of symptomatic manifestations
Symptomatically, benign paroxysmal vertigo manifests itself in the form of a feeling that objects around are rotating, this feeling appears after a sudden change in body position.
Paroxysmal dizziness usually manifests itself in the morning after sleep; it is difficult for a person to orient himself in space after getting out of bed.
The duration of the paroxysmal period is, as a rule, no more than three minutes, then it goes away on its own without the use of auxiliary techniques.
Additionally, benign paroxysmal positional vertigo manifests itself in the form, which is a common symptomatic component for all types of vertigo.
What is important in diagnosing the disease is that benign positional vertigo is not accompanied by syndromes of organic disorders of the nervous system.
With this pathology, no pathologies develop in the organs of hearing, vision or smell. Thus, the disease does not pose a particular threat to human life, but causes some discomfort.
Diagnostic measures
To make a final diagnosis of benign positional paroxysmal vertigo, specially designed functional diagnostic tests Dix-Hallpike.
The Dix-Hallpike test is a targeted technique used to diagnose the disease.
To carry out this test, the doctor lays the patient down on the bed, then takes the head with both hands and rotates it in front to the sides around then, holding the head, lays it on the bed. After the exercise, the doctor should ask how the patient is feeling.
Usually, people who have benign positional vertigo are convinced by doctors that dizziness after such a shake is a normal condition for them.
Objectively observed in the patient, nystagmus, which is facing the floor to the side or to the top, depends on the immediate localization pathological process in the semicircular canals of the inner ear.
In case of a negative effect, the exercise should be repeated a few minutes after rest. Sometimes it happens that after diagnostic test in a supine position positive result it is not possible to achieve, but the condition manifests itself after the patient gets up from the couch and the body acquires a sitting position.
When repeating positional tests, the severity of the results as a rule decreases somewhat; this also must be taken into account when making a diagnosis. As an addition to the positional test, you can use not only rotation towards the head, but also the entire body.
The most difficult for patients to tolerate is a change in body position from lying to standing.
Instrumental studies
Techniques for assessing the severity are used as instrumental diagnostics of the disease; for this purpose, techniques such as electrooculography and videooculography are used.
In order to exclude organic pathology from the central nervous system or oncological pathology patients need to undergo magnetic resonance imaging brain. To exclude pathology from otolaryngology, it is necessary to undergo a consultative examination with an appropriate specialist.
Differential diagnosis of benign positional paroxysmal vertigo
Unlike tumor-like formations in the brain, as well as pathologies in the posterior cranial fossa, with the benign development of vertigo, there are no signs of damage to the sympathetic and parasympathetic nervous system, common features are symptoms of impaired balance and positional dizziness.
Repeated positional functional testing for ordinary dizziness is usually characterized by a decrease in the severity of the positive result, since in organic pathology, repeated testing does not affect the severity of the result.
Nystagmus of a positional nature can also manifest itself in a disease such as an acute circulatory disorder of the brain, while all the symptoms of damage to the nervous system remain.
Therapeutic measures to eliminate pathology and discomfort
Conservative treatment without the use of drugs includes the following methods:
Brandt-Daroff method.
The patient can perform this exercise independently at home.
To carry out this technique, the patient needs to sit in the center of the bed and bend several times from side to side. Then the patient is pricked back horizontal position and repeats the movements in a lying position.
It is necessary to rest the body for a minute, then repeat the indicated Brandt Daroff exercises.
The method for treating the disease is repeated three times throughout the day. The duration of the procedure is determined individually depending on the general well-being of the patient.
Semont maneuver
This technique can be performed either independently or with the help of a qualified specialist.
The patient sits on the bed, the doctor takes the patient's head with both hands and turns it sharply, then injects it on the same side without changing the position of the head relative to the original plane.
The patient should lie down until all discomfort disappears.
After rest without changing fixed position The patient's head is returned to a sitting position, the head is turned and placed on the opposite side, the patient should also rest. This exercise is repeated 2-3 times, once a day.
In cases where a patient suffering from benign paroxysmal vertigo has a life history of pathologies from the cardiovascular system, cardiac tonic drugs are administered before the procedure as a specific predication.
If nausea and vomiting occur during the procedure, patients are prescribed antiemetic drugs.
Epley maneuver
A procedure of this nature is carried out only by qualified specialists. Feature this method is that the procedure is carried out using smooth and slow body movements.
The patient should initially sit on the couch, the doctor takes the head with both hands and fixes the head, turning it to the side in the same position, the patient’s head is placed on his back. After this, the person’s body is turned over on its side, and then slowly seated in its original position.
This method non-drug treatment is very effective and in most cases, repeating two or three sessions can help completely get rid of the pathological condition.
The effectiveness of this method depends entirely on how professional the specialist performing this procedure is.
Lempert maneuver
This technique is carried out exclusively by a qualified specialist. The initial position of the patient should be sitting along the couch. Turning the head forty-five degrees, fix it in the plane of the horizontal body on the side of the focus of the pathological condition.
After this, the patient is placed in a supine position on his back and the position of the head is slowly changed in the opposite direction, then the head is turned to the other side and the position of the body is changed from back to stomach, while the head should rotate together with the human body.
The exercise can be repeated several times, but with the condition of maintaining a rest period.
Surgical technique for treating the disease
Surgery is performed if conservative therapy the disease showed absolutely no positive results.
This treatment method is carried out very rarely and in quite exceptional cases.
For this purpose, the following techniques are carried out surgical intervention How:
- filling the lumen of the semicircular bony canal of the inner ear with fragments from the bone structure, which is taken from another part of the skeleton of the human body. The most optimal bone for transplantation is the tibia;
- selective removal of nerve endings that innervate the vestibular canals of the human inner ear;
- total removal of structures and spongy substance of the bone labyrinth;
- destructive destruction of labyrinth structures using specially selected laser installations.
Absolutely all surgical methods are extremely traumatic for humans and therefore should be performed only for special medical indications.
After surgery, the patient in mandatory held antibacterial therapy in order to prevent the development of complications of an infectious nature.
To prevent dysentery as side effect from antibiotics, the patient is prescribed probiotics in combination.
Prevention of disease
Preventive measures for benign positional paroxysmal vertigo have not been developed to date since they are not fully understood etiological factors development of the disease.
The pathological condition may persist for several days or weeks after therapeutic measures. As for the restoration of ability to work, it may also be difficult for several weeks, but one should take into account the fact that benign positional vertigo can recur over time and when such a moment occurs is not known.
Forecast
The prognosis for recovery is usually favorable; this condition does not pose a particular danger to the patient’s life. Depending on what disease or injury could trigger the development of this state Further recovery and the effect of the treatment depends.
Forecast for full recovery also depends on how timely the patient applied for qualified medical care.
Danger of this disease is that it is quite difficult to carry out diagnostic measures, and if it provokes a disease infection inner ear with neglected infectious process infection can spread into the cranial cavity and lead to death for the patient.
Videos on the topic
More about the Author.
BPPV is a fairly common pathological condition that occurs in most patients who seek medical help. This dizziness is caused by most lesions of the vestibular system.
The pathological condition occurs most often during movement or change of position. Benign dizziness lasts relatively short time. Even simple ones physical exercise capable of causing symptoms.
For more information about the disease, watch the video:
More often, signs of this type of dizziness appear in people over 50 years of age. In addition, it is diagnosed several times more often than in men. BPPV differs from other types of dizziness in that you can cope with it on your own. Moreover, treatment of benign paroxysmal positional attack is almost always effective.
BPPV has some distinctive symptoms that allow a correct diagnosis to be made during the first examination by a doctor.
How does pathology develop?
The vestibular apparatus is located in inner ear in the semicircular canals, which widen at the ends and end in a small “ampulla” containing the ducts of the membranous labyrinth. It contains a specific liquid of viscous consistency, which is associated with receptors.
Structure of the vestibular apparatus
Paroxysmal benign positional vertigo occurs due to the precipitation of calcium salts (otoliths) in this capsule. Further, they contribute to irritation of receptors, due to which a pathological condition appears.
Causes of BPPV development
It is not always possible to determine exactly what exactly caused such dizziness. However, there are some known causes that contribute to symptoms:
- Trauma to the skull, in which the otoliths are torn away from their permanent location.
- Inflammation of the vestibular apparatus due to a viral infection entering the body.
- Meniere's pathology.
- Surgery on the inner ear.
- Alcohol intoxication.
- Treatment with some types medications.
- Spasm of the labyrinthine artery, as a result of which normal blood circulation of the vestibular apparatus is disrupted.
These reasons are the most common. Although sometimes the etiology of BPPV cannot be determined. Therefore, it is better to get examined.
Paroxysmal positional vertigo affects almost everyone in the same way. Symptoms have the following features:
- A person experiences sudden attacks that appear during certain movements or in a specific body position: with a bowed head, a bent neck.
- Often, positional vertigo does not last more than half a minute.
- A person with such a lesion is able to independently determine sore ear, since it is from his side that the attack will be noted.
- During paroxysmal positional vertigo, nausea often occurs.
- Basically, the pathological condition is single, although periodic attacks (up to several times a day) are not excluded.
- If the patient does not perform actions that provoke dizziness, then it will not appear.
- The attacks always go the same way, clinical picture never changes.
- Most often, benign dizziness develops in the morning and before lunch.
- Others neurological problems this pathology does not cause.
- The attack can occur suddenly.
Not typical for BPPV headache, tinnitus or hearing impairment.
How is the disease diagnosed?
Benign paroxysmal positional vertigo is diagnosed quickly and easily. The doctor just needs to listen carefully to the patient’s complaints and ask a few questions. However, in order for the diagnosis to be made as accurately as possible, the doctor can perform a special Dix-Hallpike test.
Dix-Hallpike maneuver technique
It's not difficult to do. To do this, the patient is asked to sit on the couch, and the doctor turns his head to the left or right 45 degrees. This way the head is fixed, and the patient quickly lies on his back. The rotation angle must not be violated. And your head should be tilted back a little, that is, slightly hanging off the couch. Next, the doctor should observe eye movements and ask the patient about his sensations.
If the test is positive, the doctor can make a diagnosis. In order to notice nystagmus (eye movement), a specialist will need special glasses. Infrared motion detection is also used.
For a detailed story about the diagnosis, watch the video from Candidate of Medical Sciences, Associate Professor of the Department of Otolaryngology, Russian National Research Medical University named after. N. I. Pirogova Alexandra Leonidovna Guseva:
Diagnosis must be differential to exclude the presence of brain tumors. In this case, additional instrumental methods studies: MRI or CT. Characteristic of serious brain damage is the presence of neurological signs, which are completely absent in paroxysmal vertigo.
The patient should also exclude stroke and vertebrobasilar circulatory failure. They are characterized by additional symptoms, which do not appear in paroxysmal positional vertigo.
Classification of pathology
So, the form of BPPV (benign paroxysmal positional vertigo) depends on the location of the calcium bicarbonate salt particles:
- Cupulolithiasis. In this case, the particles are localized on the cupula of the vestibular receptor channel.
- Canapolitiasis. The location of the particles is in the channel cavity.
When making a diagnosis, it is necessary to indicate which side is affected.
Features of treatment of the disease
Benign paroxysmal positional vertigo can be eliminated with the help of medications, as well as special physical therapy exercises. Naturally, before prescribing treatment, the causes of the development of pathology should be accurately determined.
Concerning drug therapy, then the patient may be prescribed the following drugs:
- For the treatment of nausea and vomiting in benign paroxysmal vertigo: Cerucal, Metoclopramide.
- To relieve emotional stress.
Prices in Russian pharmacies for drugs to normalize blood circulation in the brain and the functioning of the nervous system
- Helping to normalize blood circulation in cerebral vessels: “Cinnarizine”, “Bilobil”, “Tanakan”.
- Antihistamines: Dramamine (helps eliminate nausea, as it is intended for the treatment of motion sickness in paroxysmal benign vertigo).
- Vestibulolytic agents: “Vestibo”, “Betagistin”, “Betaserc”.
With high intensity paroxysmal dizziness, treatment is carried out with bed rest. In particular difficult cases Surgery may be required. Medications for benign positional vertigo are used during the acute and severe course of the attack.
After taking medications, treatment continues with the help of positional maneuvers that help stabilize the functionality of the vestibular apparatus, increase its endurance, and improve a person’s balance. Exercises can also reduce the intensity of dizziness, as well as reduce the frequency of their occurrence.
A neurologist talks about the stages of treatment and diagnosis. chiropractor Anton Kinzersky:
Concerning surgical treatment, then it is performed only in 2% of cases when maneuvers are ineffective. The following types of operations can be used for treatment:
- Transection of some selected nerve fibers in the vestibular apparatus.
- Treatment using filling of the semicircular canal, in which crystals cannot get inside.
- Laser destruction of the vestibular apparatus or its complete removal from the affected side.
Benign paroxysmal positional vertigo with surgical intervention is eliminated quite quickly. However, such treatment may cause the appearance irreversible consequences. For example, those nerve fibers that have been cut cannot be restored back. Regenerate after destruction vestibular apparatus It’s also unlikely to succeed.
Exercise to combat dizziness
Paroxysmal dizziness can be eliminated by regular exercise, which promotes faster dissolution of calcium salts. In this case, treatment can be carried out without the use of medications. This is useful if childhood is a contraindication to the use of medications.
The following exercises are considered effective:
- Brandt-Daroff method. To perform this exercise, a person will not need outside help. He needs to sit in the center of the bed and place his feet on the floor. Now you should lie on your left or right side and turn your head 45 degrees upward. You need to stay in this position for half a minute. Next, the patient needs to take the original position for 30 seconds. After this, the action is repeated on the other side. The patient should do 5 repetitions. If the attacks have stopped and paroxysmal dizziness is no longer observed for 3 days, then the exercise can no longer be done. This kind of gymnastics is quite effective, and even a child can do it. However, there are more effective exercises which should be performed under the supervision of a physician.
- Epley maneuver. To treat BPPV in this case, the following movements are made: the patient sits along the couch, and his head turns 45 degrees in the direction where dizziness is observed. At this time, the specialist fixes the person in this position. Next, he needs to lay the patient on his back and further tilt his head another 45 degrees, after which it turns in the other direction. Now the patient should be placed on his side, with his head turned to the healthy part. After this, the person should sit down and lean towards the side where BPPV is observed. Then he can return to his normal position. In order to eliminate the attack, the exercise should be repeated 2-4 times.
Dear readers, for greater clarity, we recommend watching the wonderful video of Dr. Christopher Chang (turn on Russian subtitles, original in English):
- Semont exercise. The person should sit on the bed and put his feet down. At the same time, the head turns 45 degrees in the direction where positional vertigo is not observed, and is fixed with the hands. You should lie down on the affected side. You need to stay in this position until the attack completely stops. After this, the patient needs to lie on the other side, and the position of the head does not change. So he will have to lie down until the attack stops. If necessary, the maneuver can be repeated.
- Lempert exercise. So, in this case, BPPV is treated as follows: the patient needs to sit down along the couch and turn his head to the affected side by 45 degrees. When performing this exercise, the doctor must hold the patient the entire time. Next, the patient lies on his back, and his head turns in the opposite direction. After this, a turn is made towards the healthy ear. Now the patient needs to be turned onto his stomach, and his head - nose down. Next, the patient turns to the other side, and the head is affected.
For clarity, we suggest watching the video:
If treatment for BPPV was started on time, then it does not pose any danger to life. Therefore, it is better to consult a doctor when the first signs appear. It is the specialist who must determine what medications the patient needs, as well as what exercise will be most effective for him. It is especially important to quickly contact specialists if a child is sick.
It should be remembered that sometimes performing such exercises can provoke too much positional vertigo, accompanied by vomiting and nausea. If such an effect is present, then the doctor prescribes Betagistin to the patient. It should be taken before performing gymnastics.
Treatment of the pathology must be carried out so that the patient’s condition does not worsen over time. To ensure that attacks no longer take a person by surprise, he needs to see a doctor and undergo appropriate therapy. In most cases, the prognosis is positive.
