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Benign Paroxysmal Positional Vertigo BPPV/Ear Rocks

History: T.H. is a 63 year old male who came to The Center for Balance complaining of room spinning vertigo while rolling over in bed onto his right side, reaching overhead, and bending to pick up objects off the floor. Patient describes his symptoms as, “room spinning when I lie down and when I wake up in the morning causing me to be sick to my stomach, someone told me my ear rocks or ear crystals are out”. Patient is presently employed as a lawyer and he and his wife enjoy walking, gardening, and social activities. Patient past medical history is unremarkable. Patient prior level of function; independent activities of daily living without vertigo or dizziness. Patient unable to perform independent activities of daily living safely because of episodes of vertigo causing severe dizziness and unable to maintain balance during episodes.

Examination:  Patient demonstrated a positive Dix-Hallpike test for Benign Paroxysmal Positional Vertigo (BPPV) in his right ear.

Assessment: Patient demonstrating BPPV right ear, room spinning vertigo.

Treatment: Therapist performed modified Eply maneuver (particle repositioning technique to put crystals back). Patient was given home precautions and education material on his condition and treatment course.

Treatment Outcome: Patient demonstrating negative Dix-Hallpike room spinning vertigo testing after one treatment sessions. Patient able to roll in bed, reach overhead, and bend without vertigo episodes. Patient has returned to prior level of symptom free activities of daily living.