Bpv/ inflammation of the middle ear

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Since March of 2017 I have been to my medical doctor numerous times and ENT with no real answers they diagnosed me with having inflammation of the middle ear then they diagnosed me with having positional vertigo then they diagnosed me with having bpv and I am still experiencing symptoms is there anyone out there that could give me any advice as to what to do to alleviate these symptoms. It has totally disrupted my life like I can't do much of anything I can't drive I can't enjoy my grandchildren they say there's nothing they can do but antivert I can't take those I can't take any kind of anti-inflammatories I'm allergic to them is there any other thing out there

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30 Replies

  • Posted

    Bpv is benign positional vertigo. If that's what you have they should be treating it as such with VRT. Diazepam (valium) can also help with symptoms. Some get relief from meclazine. It didn't help me at all. Some docs and ENT's seem to toss around the bpv diagnosis when they don't do the proper testing or can really figure out what's wrong. Happened to me. Been fighting a losing battle with it for about 11 years. Finally the usual bpv treatments stopped helping all together. Got a new doc who sent me upstate to a neurotologist. He said without a doubt I have menieres. That's why it's been gradually getting worse and other treatments not helping. If it's just bpv a epiley maneuver should help, and VRT should help get rid of dizzy spells. If they don't help, get your doc to refer you to a neurotologist. They specialize in the vestibular system. He can help define what is causing the symptoms then treat it properly.

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  • Posted

    If it was a simple inflammation someone should have given you steroids or a steroid taper script to reduce inflammation.
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  • Posted

    BPPV is positional vertigo, and it has nothing to do with ear inflammation as far as I know. As the other poster says, if it's an inflammatory condition you should have been prescribed short-term steroids.

    If it's BPPV, the treatment is the Epley manoeuvre, not VRT. I had two months of misery with BPPV at the start of this year, but was finally referred to a vestibular physiotherapist, who cured me with the Epley in a single session. This is a manoeuvre that repositions the crystals in your inner ear to where they're supposed to be, by putting your head through a series of movements.

    This was the second time I'd had BPPV (once in each ear). The last time it happened, 20-odd years ago, I saw an ENT doctor who didn't seem to know what he was doing, and temporarily made it even worse.

    If you possibly can, get your GP to refer you to a vestibular physiotherapist. They can easily diagnose or exclude BPPV. In fact, you can do it yourself. Look up the Dix-Hallpike test on-line. You can do this at home. (No need to hang your head over the end of the bed like it says, just throw yourself down quickly.) If you get severe spinning just for a few seconds after throwing yourself down, you probably have BPPV on the side to which your head is turned. If not, or if the spinning lasts more than a few seconds, then it's something else.

    It's quite safe to do the Dix-Hallpike at home, it won't do any further damage. But don't attempt the Epley without supervision, as this can make things worse.

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    • Posted

      In theory, all physiotherapists are trained in the Epley. But then so are all ENT doctors. In theory. In practice, the situation can be somewhat different...

      That's why I suggested doing the Dix-Hallpike test yourself. At least you'd know then whether you were actually dealing with BPPV. You can more or less diagnose it from the symptoms anyway. Do you experience brief episodes of spinning, accompanying by a sensation of falling (and sometimes really falling) when you tilt your head in a certain direction? Do you have a problem with attacks of spinning on lying down or getting out of bed? These are classic BPPV symptoms and if you don't have them you probably don't have BPPV. In addition, BPPV usually causes a generalised sensation of unsteadiness and a feeling of "being on a boat". However, it's the sudden attacks of a spinning sensation when tilting your head that will really clinch the diagnosis.

      Even if it's not BPPV, a specialised physiotherapist - or at least one who's had experience with vestibular problems - would probably be able to help you a bit. Failing that, you should try and get referred to a neurotologist or a specialist vertigo clinic, if there is one in your area. I understand that the situation for getting vestibular help is a bit patchy in the UK.

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    • Posted

      Most of my episodes I can be perfectly fine and then in the snap of a finger I get dizzy and got to grab onto something and feel dizzy for a little bit and then it goes from that to me laying down and still feeling like I'm rolling in my bed and even sometimes I'll be standing and it'll feel like somebody has literally pushed me to the floor even though I'm still standing up . Then I got nauseous. After reading your reply I called my primary care physicians office and have an appointment to go in on Wednesday because I told them I would like some sort of therapy for this. There have been times when I have been driving and had an attack and had to pull over and try to wait it out until the spinning calm down and was able to make it home. There was also a time I was taking a shower and while I was in the shower I felt okay but I know I was moving my head around rinsing my shampoo out and the minute I stepped out of the shower I went into an attack . This is just a very scary symptom and not much medical help for me so far.

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    • Posted

      That feeling that someone has pushed you over does sound a bit like BPPV, though I experienced it rather as someone pulling the ground from under my feet. However, if the spinning is going on for prolonged periods it's more likely to be something else. Although BPPV causes constant feelings of instability and slight movement of the ground under your feet, the attacks of violent spinning are short-lived and always follow a sudden head movement.

      From your use of language it looks as if you're in the US. I hope that's the case, as I suspect that means you might have better access to the care you need than if you were in the UK (provided you can afford it, of course).

      I'm glad you're going back to your doctor. Don't let them fob you off, insist on seeing a specialist of some sort, preferably a neurotologist. They'll have the best overview of conditions like yours.

       

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  • Posted

    Hi Joyce,

    Did any of the doctors try doing any maneuvers for your positional vertigo? (BVP)

    Have you tried taking Serc?

     

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    • Posted

      They did their test for diagnosis. They layed me down and turned my head and brought me up really quick and of course I was dizzy. But as far as any manuvers to help me ...no . What is serc?
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    • Posted

      I have an appointment with Dr on Wednesday. Iam going to request further testing be done. I've gotten alot of information today here and I am not at all happy with the way my doctor has handled this since finding some answers here . They just said you have this and get used to it basically

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    • Posted

      Did that to me years ago. Some cases are caused by simple things like ear infections etc. Usually they try the meneuvers first. Then VRT . When this does nothing they then step it up. Unless they are lazy docs. Heard of a few tell ppl it's in there heads, anxiety, pms, all kinds of stuff.

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    • Posted

      Has to be a neurotologist. Not neurologist. Seen neuro. Was in and out in 5 minutes. Said he's a brain doc. Nothing wrong with my brain. Neurotologist does brain and connections to it from your vestibular system. They are sometimes few and far between. I travel 1 and a half hours one way to see one. He tryed diuretics to get rid of fluid in inner ear. Didn't work. Have 2 apps at end of July for inner ear injections. He didn't say if he's going to use steroids or antibiotics. Has me nervous.

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    • Posted

      I know what you mean ! I used to be able to drive every where and no Iam pretty much house bound ! When I feel ok I still am afraid to go out and take a chance on driving. It's really scary

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    • Posted

      Hi Joyce, Sounds like the Dix-Hallpike test. Can you be more precise about how/when you felt dizzy? Did everything go into a wild spin the minute they laid you down? And was it only with your head turned to one side? (They always do it twice, with your head turned to different sides.)

      That sounds like it could have been a positive for BPPV. On the other hand, if it was an ENT doctor doing this, and if he knew how to do the D-H, I would have expected him to go straight on to the Epley manoeuvre. On the other hand, many of us on these boards have had less than favourable experiences with ENT doctors.

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    • Posted

      If you were dizzy with the positioning of your head, that is bppv. I do not understand why they would not do the maneuvers on you.

      If you are interested I have some very good videos on this. Just PM me with your email address, and I would be more than happy to send to you.

      My postional vertigo happens seasonally.  Weird.  It happens in Sept/Oct and then again in  march/April.

      Serc is a medication for menieres, but my doc has given it to me many times in the past., It is a betahistine

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    • Posted

      Well, it will diagnose whether or not it's BPPV. It's specific for that, provided the nystagmus provoked by the movement only lasts a few seconds. If it's not BPPV then you're correct - the DH won't tell you what's wrong. I think it's a useful place to start, as BPPV is so easy to cure.

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    • Posted

      DH tells the side. Then they do epely to correct bppv. In my case it didn't do a thing. Menieres is a fluid build up in the middle ear. It can cause the I'm balance and crystals to move. Epely does nothing cause it's not bppv. Kinda made me worse. Then doing VRT added to the dizziness and vertigo. They usually do the DH, then epely to the side that has the reaction to DH. If it doesn't help, then a VNG and other testing is required to diagnose what's actually going on.

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    • Posted

      Reading all the posts on these boards, I've come to the conclusion I got lucky with this latest go of vertigo. Doubly lucky. Lucky it was only BPPV rather than something less treatable, and lucky I managed to stumble on a practitioner who knew exactly what he was doing. They seem to be about as rare as hen's teeth, judging from my own experiences and what I read on here!

      The first episode was about 25 years ago. I'd trained as a nurse in the 1960s but hadn't specialised in ENT (neuro was my thing) so I didn't really know what was going on when I first got vertigo, except it was most likely inner-ear related. Because of my neuro training, I also knew of course that it might be something more sinister. No internet in those days, so I couldn't do much research for myself.

      Saw an ENT, who did some very unpleasant tests - caloric test, with water in my ears, spinning me around in a chair etc. With benefit of hindsight, it's obvious to me that that first attack of vertigo was BPPV too. The spinning/falling attacks only lasted seconds and were 100% generated by head position; and I had no eye symptoms apart from the usual BPPV thing of the horizon jumping about when I was walking. So why on earth he decided to put me through all that is a mystery. He then attempted some kind of manoeuvre - not sure whether it was the Epley at this distance - which made me feel even worse, and I threw up on the floor of his consulting room. He told me there was nothing he could do, but that it would wear off. No diagnosis.

      It did indeed wear off after about a year of misery, but returned at the beginning of this year. By comparing my symptoms, I now realise the two episodes were identical, but in different ears. This time round I again started with an ENT, who ordered his nurse to flush a plug of wax out of one ear, then sent me for a hearing test. He saw me again for about 2 minutes after this, and told me my ears were fine and the consultation was over. He refused to even talk about vertigo.

      Thanks to my GP, I was then sent to a fantastic physiotherapist specialised in vestibular problems. He used the latest infra-red video goggles to track nystagmus during the various movements. I was pretty nervous after my experience of 25 years back, but he assured me he wouldn't proceed to the Epley or any other manoeuvre if the Dix-Hallpike was negative. He also said he was trained to recognise other conditions from the nystagmus and could refer me to a neurotologist if necessary.

      In the event, it was text-book BPPV, right posterior canal, and he fixed it on the spot with a single Epley. Apart from a month of severe headaches after that - which I realised were due to my arthritic neck having seized up during two months of being scared to move my head - I haven't looked back. My sympathies are with you and everyone else on here who don't have such an easily fixable cause for their vertigo. I could also wish for more knowledge about vertigo among the medical profession, not least ENTs!

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    • Posted

      I lost alot of faith in regular ENT's. Seen a couple who did absolutely nothing. And I know they could have atleast did the meneuvers to try to help. This last bout I been to the ENT 4 times. All he did was look in my ears. I know he's just milking my insurance. I even went to him once to remove some wax build up. He looked said yes, you have build up, come back next week. I explained in 3 days I was going up north to specialist for more testing and needed it cleared. Said nope, next week. I called up north, doc said cancel your follow up with him. I will clear it before testing. I said ok. Lol. He did both ears and didn't charge me for it. Other ENT charged $300 and did nothing. So far he's made $1200 and did nothing more than look in each ear.

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