Odd reaction 24 hours post-Epley

I'm sure everyone on these boards knows me by now, but brief history.

72-year-old woman recovering from my second attack of BPPV in 30 years. The first attack was unsuccessfully treated by an attempted Epley manoeuvre performed by an ENT, and ended up lasting a year or so. Second attack (in other ear) started 9 weeks ago. It was improving very slightly on its own, but my GP referred me to a specialist physiotherapist.

He performed the Epley manoeuvre on me yesterday, manually but assisted by infrared goggles (to pick up the fine detail of the nystagmus and guide the manoeuvre). I felt fantastic as soon as I got off the table - not the slightest sign of nausea or unsteadiness. I followed all the physio's instructions - walked for an hour shortly after the manoeuvre, stayed upright for the next 15 hours and made sure I slept on my "good" ear that night. The latter was a bit tough, but I managed to rig up something in my bed to stop myself turning over. Not the slightest unsteadiness when I got up this morning. Pottered around at home all day - no problems - then made a quick foray to my local shops in late afternoon.

That's when it started. The minute I got outside the door I realised I couldn't walk straight. This was just as bad as it was in the early days of this current attack, 9 weeks ago, but with one difference. I don't quite know how to explain this but will have a go. When the vertigo first started, it felt as if I was on a boat all the time, with the ground moving underneath me. I also felt nauseated. This gradually improved as the attack wore on. This afternoon's episode was subtly different. There was no sensation of the ground moving at all, it was just that I was having difficulty walking. It seemed to be more eye-generated this time - it was worse if I looked into the distance while walking. Just like the previous unsteadiness, it made me feel very sick.

Now back home, I immediately did the Dix-Hallpike test. This was strongly positive every time till yesterday, producing violent spinning, nausea and nystagmus I could actually feel. This evening it produced a barely-perceptible impression of spinning with no other symptoms. So it really does seem as if I'm cured.

But why the sudden problem with walking 24 hours later? I walked home from the physio's office yesterday without a single wobble. I've just read on the Veda site that people who've had BPPV for a long time before getting it fixed can react as if they "miss" their crystals. I suppose it could be this, but I certainly didn't miss them immediately after yesterday's procedure.

Any suggestions? I sincerely hope this doesn't mean it's coming back!

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