I recently had a patient with undiagnosed, or more accurately un-treated vertigo. After a detailed history to rule out the other forms of vertigo I subjected her to this test and her reaction was a case-book response. I asked her to sit on the bench and rotate her head to the right. I then lowered her back towards the end of the bench where her head hung over the edge a bit. There was a second where nothing happened giving her enough time to say: “I feel OK” and then her eyes went crazy and she then went very quiet for about 20 seconds before saying “Ugg, that felt horrible”.
The problem was a post-traumatic one for her as she was involved in a nasty crash some time ago (2 years!). The condition is caused by ‘debris’ in the semicircular canals of the ears which move about in response to gravity and so stimulate the position detecting structures in your ears giving a false reading. This is a bit like motion sickness where your eyes are out of synch with your body.
The cure is a bit tricky. You can’t open these structures up and wash the debris out, at least not yet, and you can’t take drugs to dampen down your nervous system as you’ll spend most of your time flat on the floor. However, luckily, there are slight bulges at the ends of each of your canals that with some cunning manoeuvres you can get the debris to float (sink?) into and not stimulate your canals. The manoeuvre is the Epley manoeuvre. Now, this is a tricky manoeuvre and should be done by someone on you, so in this case by me, her chiropractor, not by you with a bit of paper in your hand. And I’d suggest that if you are about to do it on a patient then practise on a well friend first off a couple of times to get it right. Once you’ve got the hang of what you are doing then lay it on.
Original from my colleague's blog.
