This subject arises quite frequently
(especially on weekends!), hence, I've included this brief discussion
here for those who forget how to perform this maneuver.
Not all dizziness is the same and people often mean different
things when they state that they are "dizzy." For
example, one person may use the term to describe sensations of feeling
faint whereas another may use the same term to mean that their entire
world is spinning around them to the point where they are unable to
walk and are praying to the porcelain god (puking up their guts!). (This,
by the way, is why good docs never try to put words in the mouths of
our patients. We want you to tell us exactly what you are
True vertigo is not really usually caused by a virus (we docs had
diagnosed this condition as viral labyrinthitis for years). Rather,
the condition most often encountered is Benign Positional Vertigo
In our heads, one can find containers (utricle and saccule) on either
side of our heads that hold very tiny "grains of sand."
Because of gravity, the grains of sand are pulled towards the earth
and stimulate tiny nerve endings (hair cells), that in turn send
positional information to the brain. The result is that our
brain senses our upright posture. If we were to stand on our
heads or turn our heads suddenly, the grains would shift position,
stimulate hair cells in other locations inside of the containers, and
our brain would interpret this change in head position accordingly.
BPV arises when some of these "grains of sand" become
'misplaced,' i.e. the leave one of the containers and enter the other.
The result is true vertigo i.e. sensation that the room/earth is
spinning around you similar to being drunk.
Fortunately, this type of dizziness is easily fixed without
the use of medications by performing the "Epley
Maneuver." (Thanks to Martin Samuels, M.D.,
Neurologist -in-Chief at the Harvard Brigham & Women's Hospital,
for sharing this trick at a Pri-Med conference a few years back!)
1. Determine which
side/direction induces the worst spinning i.e. left or right.
2. Lie down flat on your back
(supine) and wait for all spinning to cease.
3. Turn your head in the
direction that causes the dizziness.
4. As soon as you perceive the
sensation of movement beginning, immediately turn your head as far as
you can go in the opposite direction and hold it in this position
until the spinning stops.
5. When the spinning has
ceased, immediately sit up.
6. The preceding steps may
have to be repeated, but rarely does one have to perform this more
than 4 times in a row.
This maneuver works quite nicely for most people, If the
symptoms persist, then one may want to try picking up some Antivert
(an over-the-counter antihistamine commonly used for sea sickness;
generic is meclizine). If the symptoms continue to persist, a
visit to the doctor is necessary.