BPPV treatment - Wrong Ear

Timothy C. Hain, M.D. Last edited: April 3, 2021

Epley

A patient recently came in because they had positional vertigo. They saw an ENT who told them that they had BPPV on the left, because the "left eye jumped". They said that they had been doing the home Epley for 3 weeks, and they got very dizzy when they rolled to the right.

I examined them, and they were indeed very dizzy to the right, with a very powerful burst of upbeating and torsional nystagmus. I treated them with an Epley on the right, and the nystagmus and vertigo went away.

Bottom lines:

  1. For posterior canal BPPV (the most common kind), the side to treat is the one where you get dizzy.
  2. The eyes do the same thing in BPPV, and if someone says you have BPPV because your L or R eye jumps more, find another provider.
  3. If you don't get better quickly doing the Epley, you probably are treating the wrong ear, or using the wrong procedure, or maybe you just don't have BPPV. Find an expert.