Benign positional vertigo causes dizziness, nausea and sometimes vomiting from the sensation of vertigo. Because ear particles have migrated into a very sensitive part of the ear canal, you experience the vertigo and illness. Maneuvers to relocate the particles are the only cures.
Benign positional vertigo is caused by “ear particles,” or “ear rocks,” which are small pieces of calcium carbonate coming from a structure in the ear called the utricle. These particles loosen and move into the canal system of the inner ear, causing dizziness. Dr. John Epley invented a maneuver that repositions the ear rocks into a less sensitive part of the ear, which should lessen the attacks of vertigo.
The Epley maneuver is also called the “particle repositioning” or “canalith repositioning” maneuver. A doctor trained in this maneuver will have you position your head into four sequential movements for approximately 30 seconds for each position. You can take an anti-nausea medication if moving your head into these positions may cause a bout of nausea or vomiting. This maneuver should only be performed by a qualified physician in case you develop neurological symptoms, which could lead to a stroke.
The Semont maneuver involves rapid movement from one side to the other. This exercise is also known as the “liberatory” maneuver that also moves the ear particles into a less sensitive portion of your inner ear. This maneuver is not currently favored here in the United States, but it is considered to be approximately 90 percent effective after four sessions. Your doctor may teach you how to perform this exercise at home.
These exercises are done at home and are generally selected when it is difficult to determine which ear is affected most by the vertigo. You do these exercises three times a day for two weeks. After one week, the response rate is said to be only 25 percent. With this number in mind, physicians prefer prescribing the Epley maneuver, which patients can do at home.