PTZ

1 Posts
 
Posted - 04/07/2006 :  00:28:35  Show Profile  Reply with Quote
I was just wondering what the most up to date directions are to give patients after performing the Epley Maneuver to treat BPPV? Some say sleep in recliner for 2+ days while others say 1 day is enough. Any other findings or updates would be appreciated.

georgeu

6 Posts
 
Posted - 04/08/2006 :  11:48:25  Show Profile  Reply with Quote
This is what I am telling patients after performing Epley or Sermont Maneuvers:
1) Wait for 10 minutes after the maneuver is performed before going home. This is to avoid "quick spins", or brief bursts of vertigo as debris re-positions itself immediately after the maneuver. Don't drive yourself home. Have someone ele drive you.
2) Sleep semi-recumbent for the next two days. This means you sleep with yo head halfway between flat and upright (a 45 degree angle). This is most easily done by using a recliner chair or by using pillows arrnaged on a couch. During the day, try to keep your head vertical. You must not go to the hairdresser or dentist. No exercise which requires head movement. When men shave under their chins, they should bend their bodies forward in order to keep their head vertical. If eyedrops are required, try to put them in without tilting the head back. Shampoo only under the shower.
3) For at least 1 week, avoid provoking head positions that might bring this on again.
Use two pillows when you sleep.
Avoid sleeping on the "bad" side.
Don't turn your head far up or far down.
Be careful to avoid head-extended positions, in which you are lying on your back, especailly with your head towards the bad side.
4) At one week after treatment, put yourself in the position that usually makes you dizzy. Position yourself cautiously and under conditions which you can't fall or hurt yourself. Let your doctor know how you did.
What if the maneuver doesn't work? These maneuvers don't always work (only 80% of the time), and if they don't, then your doctor may wish you to proceed with the Brandt-Daroff exercises. If a maneuver works but symptoms recur or the response is only partial, another trial of the maneuver may be advised.

MilwPT

7 Posts
 
Posted - 10/11/2006 :  20:57:32  Show Profile  Reply with Quote
I work with a neurologist and treat a lot of BPPV patients. I have my patients wear a soft collar for a few days after treatment, to avoid head movements. This seems to be pretty effective.