Epley maneuver moves ear crystals

Published 5:55 am Saturday, June 1, 2019

DEAR DR. ROACH: I am a 67-year-old male in excellent physical health. The only issue I have is occasional bouts of vertigo. The frequency has increased the past couple of years to about every two weeks.

I do the Epley maneuver to relieve the symptoms, which go away one or two days after doing so. Is there any new research or treatments for this? I am also curious about what foods might be contributing to the onset of vertigo. — R.W.

ANSWER: Vertigo is a sensation of movement when there isn’t any. Each ear contains an organ of balance, also called the semicircular canals, which work by the movement of hair cells inside those fluidfilled bony structures. Sometimes small crystals (called otoconia) form in one semicircular canal. These press on the hair cells and cause the two organs of balance to send conflicting signals to the brain about movement, which is perceived as vertigo.

Diet is not likely to have a significant effect on causing or treating BPPV.

The Epley maneuver, like other repositioning maneuvers, is designed to move the crystals out of the semicircular canals.

I have read about surgical options for refractory BPPV, but I have had success referring patients to vestibular rehabilitation, performed by trained occupational or physical therapists.