Treating the canalith jam form of BPPV

Blockages in the canal that keep particles from exiting with maneuvers are very rare, fewer than 1 in 100 cases of BPPV.  We don’t yet know exactly how rare it is.  However, these rare cases can still be  treated with maneuvers.  Some modifications are needed to get the particles past the blockage.

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Canalith jam: a rare cause of BPPV

Rarely, maneuvers don’t seem to work, even though the vertigo seems to be BPPV.  The affected person is able to make spells happen by making head movements like lying down, rolling over or tipping the head up, but the particles seem to be stuck, unable to exit the ear.   Each time a maneuver is done, the vertigo remains the same, rather than improving.

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H-BPPV and Entrapped Particles

Sometimes maneuvers for H-BPPV don’t seem to work, and this is especially true for the apogeotropic type, when the eyes seem to beat toward the ceiling when lying on your side.  It’s very rare to have this happen.  Most of the time, lying flat on your back until the dizziness stops and then doing one of the maneuvers for H-BPPV is enough.  About 1 in 100 people, however, will have particles that get entrapped in the canal.  Because they are stuck, they can’t be removed easily with a simple maneuver.

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