Epley Maneuver Done For BPPV. Started Feeling Dizzy And Nausea. What's Going On?

Posted on Tue, 2 Apr 2013

Question: I had the Epley Maneuver carried out about 48 hrs ago. Therefore just coming out of the time w during which I was told to be super careful- sleep at 45 degrees etc. I had a strong dizzy/falling reaction at the end position of the maneuver and am hopeful that the treatment was successful however now I seem to have a slight feeling of nausea quite a lot of the time - not any dizziness- does the nausea feeling mean it has not really been successful?

Answered by Dr. Polash Sannigrahi (48 minutes later)

Hello XXXXXXX

Thanks for your query.

The medical history as mentioned in your post suggest that you might be having Benign Paroxysmal Positional Vertigo.

In this condition, there is dis-lodgement of calcium carbonate crystals from a membrane in the inner ear, which settle within the semicircular canals.
When the head is turned or moved, they brush against the sensitive hairs within the semicircular canals, sending false signals to the brain resulting in dizziness, nausea and vertigo.

Epley maneuver was designed to move the crystals out of the semicircular canals, so that they can adhere to the membrane again.

However, Epley Maneuver may induce a sensation of nausea.
Though the sensation subsides on its own, symptomatic relief can be obtained by taking anti-emetics, limitation of head movements & maintenance of certain postures as advised by your Doctor.

If symptoms still persist, it may indicate failure of the maneuver & it has to be repeated again.
Under such circumstances, it will be better to consult an ENT specialist for further management.

Wishing you a Good Health.
Let me know if I need to clarify further.
Thanks & take care.

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Polash Sannigrahi (1 hour later)

When you say that the Epley maneuver may induce a sensation of nausea, do you mean that even when the maneuver leads to a longterm success= cessation of dizziness- this is/can be a fairly common, recognised symptom which generally subsides in time?

Answered by Dr. Polash Sannigrahi (7 hours later)

Hello,

Thanks for writing back.

Presence of nausea can be seen even after a successful Epley maneuver.
It subsides on its own & is symptomatically managed, as I have already discussed in my previous answer.

However, for safety reasons, it will be better to consult your treating physician if the symptoms persist even for more than 3-4 days.
A proper examination needs to be done to find out whether the sensation of nausea is due to Epley maneuver or due to some other cause.
Based upon that, further management steps could be taken.

Hope I have been able to answer your query.
Please let me know if you have further questions.

Wishing you a Good Health.

Thanks & take care.

Above answer was peer-reviewed by : Dr. Raju A.T