With all your knowledge combined, maybe we can come up with an answer!

[raebabelvn, LVN]

Ok nurses... I want your input on this!

This is about my sister. Last Sunday, Easter Sunday, she started getting dizzy. The dizziness progressed and she began to vomit. She went to the ER that following Monday and the ER doc diagnonsed her with Benign Paroxsymital Positional Vertigo (BPPV). She prescribed her metclizine and valium for when the dizziness was extreme.

I did some reading and everything I've read on BPPV said that the dizziness lasts a few minutes. Her dizziness has been constant for over a week straight now. The severity comes and goes but nonetheless, its still there.

Friday she saw a neurologist. They did a head ct, but the results came back normal (thank goodness!). She saw her regular doctor today and she took her off the metclizine because it wasn't doing a single thing for her and put her on valium only, plus prescribed her something for the nausea.

She says its the vertigo, so did the neurologist and obviously the ER doc. But heres some strange things.... her BP has been very very high. Normal for her is 100/60. All week its been 130-140/80-90. And she had a low grade temp today when she went in.

Now... with all the knowledge everyone has here, what do all these things point towards? I'm thinking its more than the BPPV. What about you?

[faith716rn]

Has anyone mentioned meniere's disease (spelling)? It's an inner ear thing, symptoms are vertigo/dizziness. Not so sure about the nausea, but that would make sense to be nauseated if your vertigo was severe. I had a co-worker years ago who was diagnosed with it. She was put on meclizine, but it didn't always work for her. Her vertigo would be pretty bad. Worth looking into, anyway.

[annmariern]

Had a pt recently with the same symtoms, had been vomiting and unable to even open here eyes at times because of it. A ENT doc came in and performed the Epley maneuver. Within a few hours she was up and around again. Its worth a try, she can be taught to do it at home.

[raebabelvn, LVN]

Has anyone mentioned meniere's disease (spelling)? It's an inner ear thing, symptoms are vertigo/dizziness. Not so sure about the nausea, but that would make sense to be nauseated if your vertigo was severe. I had a co-worker years ago who was diagnosed with it. She was put on meclizine, but it didn't always work for her. Her vertigo would be pretty bad. Worth looking into, anyway.

Interesting... I usually go with her to the doctors so I'll mention it next time.

and what are the epley maunevers?

[tsunami62]

also something called 'labrinthitis' can cause extreme dizzyness

[annmariern]

"The Epley Maneuvers, also known as the Canalith Repositioning Procedure (CRP), are designed to treat benign paroxysmal positional vertigo (BPPV) through induced out-migration of free-moving pathological densities in the endolymph of a semicircular canal, using timed head maneuvers and applied vibration. In simpler terms, canaliths (calcium carbonate crystals) are normally attached atop a membrane in the otolith organ (or gravity center) of the inner ear. These crystals can break off for various reasons, most commonly, injury or disease, and migrate into a semicircular canal. Then, when the head position is changed, the canaliths shift, abnormally stimulating the nerve sensor (cupula) of the affected semicircular canal and creating a sensation of movement (vertigo). In treatment, the head is maneuvered so as to guide the canaliths (also referred to as otoliths or cupuloliths, depending on their placement) back though the labyrinth to where they originated. To facilitate this process, the canaliths can be tracked by observing the eye movements they cause, and by applying an oscillator to the skull. In most medical facilities, this maneuvering is done by hand with the patient lying on a table. The Portland Otologic Clinic uses special automated equipment (the OMNIAX Positioning System), which positions the patient and allows observation of eye movement via miniature video cameras. This provides an advantage in diagnosing and treating difficult or complicated cases, including variations of BPPV.

A former method was to surgically destroy the function of the balance system in the involved ear, allowing the opposite side to take over. Then Dr. Epley demonstrated that the problem could also be cured by repositioning the canaliths. Validated internationally by numerous institutional studies, this treatment is now known around the world as "The Epley Maneuvers". It provides a low risk, non-invasive and highly effective alternative."

Thats a bit long winded, basically with her head in a downward position he rotated her slowly 360 degrees; I guess it dislodged the stone. Never heard of before that day myself. Interesting to see it work.

[EricJRN, MSN, RN]

Rach,

Sorry to hear about your sister's condition! Those symptoms must be uncomfortable and pretty distressing. Unfortunately, providing medical advice (recommending treatments for specific conditions, considering differential diagnoses, etc) is outside the scope of our website and prohibited by the Terms of Service that we acknowledge on registration here.

Voicing your doubts to her physicians would be the most direct way to explore your concerns. I'm sorry that we cannot provide more help here. We do hope that she feels better soon!

[NRSKarenRN, BSN, RN]

benign paroxysmal positional vertigo and movement disorders can best treated at a facility that has a hearing and balance center---ask the doctor for one in your area,

these philadelphia centers have descriptions testing/treatment : hearing and balance center ; http://www.pennhealth.com/ent/balance/hi/

see if you can locate one in your area.

good luck

[P_RN, ADN, RN]

http://www.dizziness-and-balance.com/disorders/bppv/epley/fifth.html

Epley maneuver. I'd never heard of this but Google has.