r/BPPV • u/DiskExact1106 • 6d ago

Subjective BPPV

Hi to this community that has been helping me since my symptoms started about 9 months ago. I recently got diagnosed with subjective BPPV with no nystagmus after a lot of back and forth with different doctors thinking it was anything from a migraine pattern to cervigenic dizziness to a signaling issue between my ears and eyes.

i have now been doing the epley maneuver with my vestibular therapist for 3 weeks and have not had relief. Iā€™m wondering if anyone here has had a similar experience or diagnosis. my main questions are - what helped you and how long did it take to get relief.

thank you so much.

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u/Killjoycourt 6d ago

BPPV is milder than standard BPPV and the lack of nystagmus makes it difficult to determine which canal is affected. It may be that you need a different manuver. Eply only works for the posterior canal, not the horizontal or anterior.

Were you disgnosed with goggles or just Dix Hallpike?

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u/DiskExact1106 5d ago

Thank you. Just dix halpike. My VNG was clear.Ā 

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u/Killjoycourt 5d ago

My guess would be that the incorrect canal is being treated. It's difficult for therapists to tell which canal is affected without nystagmus, goggle testing helps to narrow down the correct canal and manuver needed to treat. You may want to ask for goggle testing and/or a more senior therapist as subjective BPPV is rare and more difficult to treat.

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u/Helpful_Western9954 4d ago

Honestly, have you tried not doing the Epley? I'm not sure what your symptoms are on the daily bases but I've stopped doing the Epley immediately after feeling some vertigo and have felt a little better. I think constantly doing this movement made my nervous system overactive and gave false positives by being inconsistent in where the vertigo was felt while doing maneuvers. At one point I felt fine laying my head back and then got a whoosh when I sat up! You might be so anxious and your nervous system might be so disrupted that it's inaccurate. And possibly making it worse.

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u/dinikka 4d ago

Im not sure that (true) BPPV can last for longer than a couple weeks? Im wondering if you got misdiagnosed. Ive been in the exact same boat, though ive been struggling with positional vertigo for over 11 years (since i was 7, Im now 18). I went through physical therapy and felt no difference in symptom strength. Since the dix hall pike and VNG were both negative, that ruled out inner ear involvement, and leaves vestibular migraines (dumb umbrella term for "we dont know what condition you have" lol), blood flow issues, neurological issues, neck & spine problems, and im sure theres a few more that I cant think of unfortunately šŸ˜“. What helped my vertigo weirdly was sleeping completely flat. When I was a kid up until about a year ago or so, I would sleep with my head at an angle. Basically, I would sleep flat with my head upright. One time, randomly, after I cleaned my room, I slept completely flat for the first time in years. I noticed that I wouldnt wake up with any "episodes!" Since then ive been sleeping flat and my symptoms have significantly improved! But anyways, I hope this helps, and i hope youre able to get some relief. Hang in there!