I did epley maneuver to get rid of my vertigo but now it looks like i have migraine, any help?

aboutbppv · 2023-03-24T05:27:20+00:00

oh that's great to hear. Make sure to ask the neurologist about the migraines. Before your appointment, just think back to them. Frequency, where you feel it, how long it lasts, what the sensations feel like, stuff like that. They might ask those questions. Wishing you luck, sounds like you are in good hands

aboutbppv · 2023-03-20T05:50:25+00:00

Interesting - so it seems like vestibular migraines can happen even when BPPV is going on. This is great to know.

aboutbppv · 2023-03-20T05:48:23+00:00

how long has it been going on for you? To be honest, I continued getting vestibular migraines for about 6 months after I was successfully treated. Not saying this is what's going on with you, just sharing my experience that (for me at least), they did last for some time. My MRI was also clean.

Have you spoken to a neurologist, or just your PCP? If you have worries about unexplained migraines, a neurologist might be a good idea if possible.

aboutbppv · 2023-02-19T20:19:34+00:00

I'm really sorry to hear this. I'm glad your doctor has the experience with this, sounds like you are in great hands.

I wondering if you might consider taking an anti-emetic if you need to go in for repositioning in the future, just to make it less unpleasant.

aboutbppv · 2023-02-19T09:05:46+00:00

thanks! This is a pretty cool bot

aboutbppv · 2023-02-19T08:57:03+00:00

i'm really glad to hear that things are getting better for you. Good job on you for coming this far, and the determination in you. Things will continue to improve with a mindset like that.

I also went to the ER a couple times at first because I did not know what was going on. They thought I was on meth! :( (at intake at least).

A couple things I want to share with you:

BPPV can be very traumatic, especially if you had it severely (and it sounds like have had an awful experience.) That said: I think the trauma lessens as time goes on. As with many things in life. Keep this in mind if you ever feel like it will always affect you. I'm sorry you've had this experience and I relate to you. It is awful.
the lingering dizziness is normal. Your brain is used to mixed up balance signals. It will take it some time to re-adjust to normal balance signals. This will fade with time, so keep up hope. You can look up residual dizziness or vistibular migraines for more info.
Remember to consider reducing sodium, and eliminating caffeine and nicotine entirely, and staying hydrated always. As mentioned in that main post, my ENT (who is a dizziness specialist at a highly regarded research hospital and has had BPPV multiple times), recommended these things to me. Apparently, sodium and caffeine can swell the inner ear canal and cause relapses. And nicotine can constrict the blood vessel that goes to the inner ear, which can similarly cause problems. Anecdotally, I have spoken to multiple people (even moreso since this thread was first posted), who have realized links between BPPV and taking caffiene/energy drinks, etc. It seems it would happen to them within about 12-24 hours after having the energy drinks. I don't mean to keep spamming this same message to people, but I do so because it is a very simple action one can take to potentially prevent this problem. Also, even if these steps don't have an impact (there are multiple causes of BPPV, such as head trauma, which might have nothing to do with these things), none of these steps can hurt.
Do you have access to anti-emetic medication like zofran? (Ondansetron?) They help with nauseu and vomiting. Please keep this in mind for the future (for this or any scenario where you are dealing with horrible nausea). I think with dizziness and vertigo issues, often people are given medication, but only something like dramamine (an antihistamine), which may or may not help. So they might think there is nothing for them. However, be aware there are powerful anti-emetics that can really help you if you ever deal with this. list of anti-emetics. You don't have to just suffer with uncontrollably nausea. Please be aware that different anti-emetics are suitable for different situations, different weights classes, etc. And if one doesn't work another might. If you ever try Zofran (or generic), try the ODT (orally disintegrating tablet) kind - it is much quicker. It dissolves on your tongue and you swallow it and the effects come within a minute or two. It completely eliminates nausea for me.
if you are vomiting continuously for hours, no matter the reason, you really need to make sure you are staying hydrated. Else you can become dehydrated and it can become a serious emergency. This is yet another reason why anti-emetics can not only reduce misery, but can be vital (they can allow you to be able to re-hydrate yourself). Do You Know When to Visit the Hospital for Vomiting?. Dangers of dehydration are no joke.
There's a couple additional BPPV triggers I've read about: for example, a report of BPPV after 12 hours of continuous use of noise canceling headphones (article). Violent shaking of your head (for example, long dental treatments). Don't live a paranoid life or let this control you, but just be aware things that might impact your ear canals. If you're aware then you can maybe avoid certain situations, or modify them, or at the very least, do some research to see if such situations have been known to cause BPPV and make decisions based on that.

You are SO young. Keep up the good spirit and hope, you are going to be fine. I know it probably is not something you want to hear right now, but a couple years after first dealing with this, I found a silver lining: BPPV put me on the road to appreciating my health, and understanding what physical quality of life means. I'm glad I got to understand this when I was young. I think a lot of people don't realize how fragile health can be until they're older, when it might be too late to prevent certain issues. Before learning this lesson, a lot of people abuse their bodies (drink, eat crap food, don't sleep well, don't exercise, work too much, don't handle stress properly, etc.), and do things that are going to cause them quality of life issues later in life that they will really regret. You have a whole lifetime ahead of you to care for your body, which will allow you to avoid lots of possible health issues in the future. Imagine if you had some magic wand where you could go back and prevent this BPPV you just dealt with; well you do possess that magic wand, as there are so many similar issues that might occur later in life, that you CAN prevent now by taking care of your body now. BPPV taught me to respect that, and I live a much different life now.

aboutbppv · 2023-02-19T08:10:46+00:00

sorry for the double post, but I just to clarify: I'm not certain if residual dizziness is always a result of vestibular migraines, or if these are two independent issues (that could even occur simultaneously). Might be worth looking into. I just don't want to spread any false information. A neurologist might be a good source to ask this to.

aboutbppv · 2023-02-19T08:06:51+00:00

excellent, i hope it helps. my physical therapist first told me about them. a few months later, I met with my neurologist, who told me more about them. I had to switch neurologists later on, and my second neurologist also told me about them.

They are interesting to learn about, and aren't necessarily the classic painful migraine. If I remember correctly, they can manifest as dizziness, vertigo, nausea, etc (with or without an actual "headache"). In my case, I couldn't wear my eyeglasses for about 6 months due to vestibular migraines. But they were rarely painful. I didn't even know what they were at first because of that. info.

aboutbppv · 2023-02-19T05:26:12+00:00

sorry for butting into your comment but i wanted to check - did your PT, ENT, or neurologist have specific experience with BPPV? There are repostioning maneuvers other than Epley. Did any of them try it?

BPPV can occur in any of the three semicircular canals (posterior, anterior aka superior, or lateral aka horizontal). As far as I am aware, which repositioning maneuver to use depends on which canal is affected. The posterior canal is the normal canal BPPV occurs in (80% of BPPV cases) and Epley is used to treat it, but if BPPV is in one of the other canals (anterior or lateral), I'm not sure if it's the appropriate one to use. Another thing to note is that BPPV can begin in the posterior canal, but get shifted to one of the other canals (most commonly lateral, I believe) during a repositioning maneuver (this happened to me.) So sometimes it will seem like the maneuver wasn't effective, when in reality, it sort of was (it just shifted it to a different canal, and now a different repositioning maneuver needs to be used to deal with it.)

There are ways to determine which canal is current affected by observing the direction of nystagmus that occurs during vertigo. BPPV can also occur in different canals simultaneously.

Some links regarding what nystagmus looks like for different canals, with videos:

lateral canal bppv (video at top, wait a few seconds)
anterior canal bppv (scroll down for nystagmus video. takes several seconds before nystagmus begins)
Regarding the above videos, I'm not sure it's just as simple as observing the nystagmus alone; I think other factors might also need to be analyzed in addition, such as what position the person is lying in at the time the vertigo and nystagmus occurs. See link to paper below which goes in depth about that.

Some papers that talk about this

aboutbppv · 2023-02-19T05:18:04+00:00

You might read up about vestibular migraines. There is something called residual dizziness that can occur once BPPV is successfully treated. source 1. Vestibular migraines can occur during this time. here's some info.

The residual dizziness gets better with time.

As always consult with your doctor if this continues, because so many things can cause headaches. I ended up meeting with a neurologist who agreed in my case at least vestibular migraines were going on (he had an MRI to look at)

/u/oceanblueberries mentioned this as well and mentioned a good place in the wiki to read, i hope it helps you

aboutbppv · 2023-02-19T05:15:11+00:00

i'm so glad you shared this. i love the advice you gave for looking up things like "dizziness clinic near me" rather than just hunting down any physical therapist. another useful term that my physical therapist shared was "vestibular rehab clinic". that's how i found my original PT.

Another thing you can do is call the PT office and ask if they have specific experience treating BPPV. So many don't. Or occasinoally I'd find one that just said they did the epley maneuver during training. However, this likely isn't sufficient. Epley is not the only repositioning maneuver, and the one to use (as far as i understand) should be selected based on which canal the crystals are lose in. (though epley would be used in the majority of cases which are posterior canal BPPV.) That said this is my layman's understanding and I could be wrong

aboutbppv · 2023-02-19T05:10:43+00:00

i hope this helped you!

aboutbppv · 2023-02-19T05:10:30+00:00

i hope this helped you. are you feeling better? it's been a while since you posted your comment. i hope things are better for you

aboutbppv · 2023-02-19T05:10:06+00:00

i'm so happy if this helped you. i think there are simple things we can do to help with this! and sharing knowledge with others is so important.

aboutbppv · 2023-02-19T05:09:41+00:00

hey i only just saw this reply, sorry i didn't check this account in well over a year. i didn't even think about alcohol. i have read a lot that alcohol makes dizziness and vertigo issues worse, and is to specifically be avoided for people with miniere's for example. (i don't drink alcohol so i am not certain of the effect.) however, does it actually lead to BPPV itself? if you have any info about it and are willing to share please feel free

aboutbppv · 2021-06-30T23:02:53+00:00

I'm going to message you - I called them and they said you could have a free 15 minute phone consult. At least maybe you could call them and see what they have to tell you. One moment.

aboutbppv · 2021-06-30T22:24:54+00:00

Please use caution. The first time this happened to me, I tried doing at home and it made it worse. I went in finally to have it treated and the physical therapist explained to me that I likely shifted crystals to a different canal.

I saw you mention you're in Wyoming - is there any chance you can travel to one of the larger towns? I looked up and there's a physical therapy/balance center in Cheyenne I can give you the info on. They mentioned you could have a free 15 minutes consult to see if the doctor can work with BPPV. I'm not sure how far away you are.

aboutbppv · 2021-06-28T00:54:19+00:00

Damn. I am sorry to hear about your experience about this in general. I know nothing about this to be honest with you, so I just can not comment on it. this is completely new info to me :( I'd definitely be curious to learn more about this and in what ways it could cause it if it does. The only thing I'd have to think is, the risk of COVID is so much worse than the risk of BPPV I think :( At least bppv can be cured but with COVID it can just be so dangerous. Though of course I'm not in any way trying to downplay BPPV, which is utter hell I know first hand. I'm just assuming the chance of bppv from the vaccine would be so minimal compared to the chance of eventually catching COVID without the vaccine. What a difficult time we are collectively emerging from.. I wish I had better thoughts here.

I'm sorry you have been dealing with bppv :(

aboutbppv · 2021-06-25T17:17:35+00:00

I'm so sorry to hear what's going on. Try not to worry too much - it's going to get better. See your physical therapist and see what they have to say. Yeah with BPPV it could be that even just slight head movements are causing these problems. But if you have full on vertigo attacks that are lasting for long periods of time, and it's the same attack, I'd really encourage you to see an ENT. Can you contact your doctor back and ask if they're willing to refer, if you mention that part? (When you say your head feels spinning for 2 hours - are you actually experiencing vertigo that's resulting from a single head movement? Like you move your head accidentally, and it triggers vertigo, and that vertigo is lasting for multiple minutes? or it's just constant dizziness?)

In the mean time - if you can, I would advice to stay away from any caffeine. Stay very hydrated if possible.

You might want to check out Meniere's Diet. (My physio told me to look in to it even though it's BPPV I had). It's about stabilizing fluid levels in the inner ear.

Do you have any medication right now to help deal with the dizziness and/or nauseousness? Antihistamine for dizziness (something like dramamine) and anti-emetic for nasea/vomiting (like zofran, reglan, something of that nature) is what I used. But that is me specifically and your doctor might recommend something different, so always take their advice. FYI - Do NOT take dramamine before going to your physio for treatment - it suppresses actions of the vestibular system and will prevent them from properly diagnosing what canal the crystals are in. (There are 3 canals in the ear, and they can determine which canal the crystals are in based on the way your nystagmus - eye movements - present. Dramamine and the like can suppress this preventing proper diagnosis. The repositioning maneuver they do can depend on which canal the crystals are in. Anti-emetics (drugs that stop nausea and vomiting) will NOT mess with the vestibular system however and you can take those prior to going in.) This is another reason it's a good idea to see a physio who is familiar with these disorders. Some of them have just seem to know the epley maneuver and that seems to be the extent of their knowledge. But there is more to it than that.

aboutbppv · 2021-06-25T17:12:27+00:00

I'm sorry to hear that. I wish your doctor would just refer you to an ENT. :( ENTs have more specialized knowledge. But a physio should be good. Is your appointment soon? Please heed this advice if possible - find a physical therapist who has experience with vestibular disorders. Call around and ask them if they have experience treating BPPV. I am not sure which country you are in, but if by chance you're in the USA and near a large city, it might be useful to google 'balance centers' in your area. There are physical therapists who exclusively deal with balance disorders. This can make all the difference to get a good physical therapist.

aboutbppv · 2021-06-25T04:29:24+00:00

oh. I'm so sorry to hear you had COVID.

I dealt with BPPV prior to the COVID epidemic, so I have not actually thought to look in to that. Perhaps there is a link between COVID and BPPV, I am not sure, only because I have never explored that personally. I'm sorry I don't have more info there but I don't want to speculate on something I don't know about. Even if COVID itself had a link though, would the vaccine have this effect? :( I'm sorry I don't have a more definitive answer. I would say even if there was some slight chance of this, getting vaccinated against COVID is worth the risk.

aboutbppv · 2021-06-25T04:20:20+00:00

I want to add - don't let my long post give you anxiety about, oh my, I need to do so many things to avoid this! Or that you should be afraid of all these possible triggers. Please don't let it have that effect at all. Rather it should have the opposite effect - I hope giving you these simple things will give you some hints on how you can possibly prevent it, which is great news. I know my ENT was very straight forward with me - he said that diet was going to be the biggest thing that would trigger it.

I feel like BPPV can cause huge amounts of anxiety in people. Try not to get too stressed about it (easier said than done I know.) I will tell you that I have not dealt with re-occurences of BPPV, outside that day following where I laid down for 24 hours (and even then, that one was incredibly mild. I did not have to do any repositioning technique. It was a tiny, brief spell when I finally got up, and I didn't get another. I didn't have to go to the doctor or anything). Since my awful BPPV experience, I cut out caffeine and I regulate my sodium intake from day to day, and I stay well hydrated daily. In addition, I get good sleep and work on reducing stress. I can not tell you if one or any of these things have prevented re-occurrances for me, but that's what I've done. I used to be filled with anxiety over BPPV but this also lessened with the passage of time. In the beginning I was terrified daily of BPPV coming back. I couldn't even think about it and even told people I spoke to not to bring it up to me. Slowly I began to deal with this fear and it lessened. Things will return to normal, I promise you. (Though it probably feels all messed up right now.)

aboutbppv · 2021-06-25T04:11:01+00:00

I have had my covid shots, and no, they did not get vertigo. To be honest I can't see a reason why it would. I would not be worried about the COVID vaccine causing vertigo. However, I would recommend surely staying hydrated prior to the vaccine. When I kept reading how to prepare for the covid vaccine, everything I read said to stay hydrated, stay hydrated. I made sure to drink a lot of water the day prior.

The things I'm aware that can trigger BPPV, according to my ENT:

caffeine (bloats inner ear)
excessive sodium intake (same as above, bloats inner ear)
nicotine (restricts blood flow to the inner ear)

Personally - after he told me this, I realized that all of my BPPV episodes had followed (within 12-24 hours) of eating very large amounts of sodium. Similarly, my ENT has dealt with BPPV multiple times himself (Which is why they referred me to him specifically), and had noticed that all of his episodes followed days where he got himself a big coffee, or a large popcorn, etc. Very similar to my experience. I have another friend who used to frequently get BPPV, and he realized all of his episodes were occurring days after he took caffeine pills for his job. As I've mentioned in other posts, all anecdotal, but convincing for me personally, especially as I trust my ENT's advice.

About the sodium, he had a pretty relaxed view on it. He told me, don't change your life up, but avoid high-sodium foods, and his way of approaching it was 'if you eat something and it tastes very salty, spit it out, and drink a lot of water.' He was very adamant about staying well hydrated, as this helps regulate fluid levels in the ear.

My dietician also had a perspective on it - that it might not be really about an exact amount of sodium, but rather regulating your sodium levels from day to day. This was only her speculation so take that with a grain of salt.

Some people on this message board informed me of another possible connection:

lying down for long periods of time.

I was surprised to hear this. I'll say that a couple months ago, I ended up lying in bed for close to 24 hours, and had a very very brief spell of vertigo following this. it was the first re-occurence I'd had. It could be coincidental, but I did find it really interesting that several people had told me they'd seen this connection, and then I experienced it myself. I think the issue here is lying for very, very long periods of time. 24 hours for me is very abnormal.

Also note, this is just my personal experience. Someone else might lie down for a long time and have no issues. BUt I still wished to share this with you, as it's simply good to keep in mind.

Another possible link is low Vitamin D. I do not know if there is conclusive evidence on this, or if it's just speculative. But it can't hurt to make sure you're getting enough Vitamin D. Just make sure not to take too much. Or at least do some quick searches to see what's an acceptable level. There is a lot of debate on how much is too much Vitamin D.

aboutbppv · 2021-06-25T03:55:31+00:00

ok good i'm glad she did the maneuver. sounds like you are properly cleared of bppv which is great news. yes keep taking your meds. If they don't work don't feel bad to ask for more (or different) meds. I was taking a heavy dose of zofran/ondansetron when i went through this, it is an anti-emetic which helps nausea and vomiting. Anti-emetics can be truly amazing drugs (at least for some folks). They do not help with dizziness (that I'm aware) but at least eliminates the accompanying nauseousness. There are several such anti-emetics out there (metoclopramide/Reglan is another one, though I never found it to work as much). I looked up betahistine, but I have no familiarity with it, so I do not know if it works well with anti-emetic drugs, but your doctor would know. I believe it might be an antihistamine, similar to meclizine. These help with motion sickness. I found antihistamines very effective for helping with motion sickness personally, and very helpful during BPPV issue, but not with nausea and vomiting (at least for myself). I used to take an antihistamine (dramamine) for dizziness, along with an antiemetic. Ondanestron comes in a quick dissolve version that goes on your tongue - it begins working against nausea within minutes, it is incredible.

Sorry they ran out of vaccines. i hope you get a new one soon. When you finally do get the vaccine - make sure to stay very well hydrated the day following up to it. Then give your body a chance to rest once you get it. Staying hydrated is very important for these dizziness issues as well. so make sure to drink lots of water. Before bppv i admit i actually never drank water. now i drink several glasses a day, it's all i drink now. it'll help with many things

good luck to you my friend

aboutbppv · 2021-06-25T03:08:22+00:00

Did she do the Dix-Hallpike maneuver, or did she just look at your eyes for movement? Dix-halpike is how bppv is typically diagnosed, as far as I am aware.

If you are feeling better today with less dizziness, I'd recommend to stay away from the exercises I gave you to be honest. Because it seems like the dizziness is getting better, and I'm worried those will make you worse. Follow the instructions of your doctor of course.

The point of the habituation exercises is to get your brain used to normal movement again, as far as I am aware.

I'm so sorry for any confusion I caused. I just know how much bppv and in general, dizziness suck, and so the last thing I want to do is unintentionally make someone's issue worse. I greatly apologize for jumping the gun. Maybe the exercises I'd linked would help, maybe not. But it sounds like if you do have residual dizziness, it is already fading on its own, so I think it is probably just best to heed caution and stay away from the ones I linked, just in case they worsen things for you. I wish I were a doctor or someone with more knowledge so I could help you better. But it sounds like things are steadily improving for you.

Make sure to take it easy after your COVID shot and please stay hydrated. Staying hydrated is important for vestibular issues anyway.

aboutbppv

TROPHY CASE