Benign Positional Vertigo (cont.)
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The definitive treatment for BPPV requires that crystals causing inflammation in the semicircular canals be moved out of those canals. This can be done by the Epley maneuvers, where the head is taken through a series of position changes that allow the crystals to be emptied out of the canals.
Epley maneuvers require a special skill set, first to know which canal the crystals are in, and second, how to "shake" the head to get them removed. Some physicians, as well as specially trained physical therapists are skilled in this procedure, which can take a patient from being immobile with intense nausea and vomiting, to become functioning normally with no symptoms during the treatment session.
If a person without these skills is not available, medication may be helpful in decreasing or resolving symptoms. In an emergency situation when a patient presents with intractable vertigo and vomiting, intravenous diazepam (Valium) may be useful in decreasing inflammation in the labyrinths.
In less severe cases, over the counter medications like meclizine (Antivert, Bonine, Dramamine II, D-Vert) may be helpful.
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