The Other 9%

A study by Nunez et al. reported that 91% of patients experiencing benign paroxysmal positional vertigo (BPPV) had resolution of their symptoms with canal repositioning maneuvers. But what about the other 9%?

Often times, these people who fall into the 9% become candidates for surgeries that involve cutting the vestibular nerve, a singular neurectomy, or a posterior semicircular canal occlusion. We do not believe that such extreme measures are the appropriate next steps for these cases.  In fact, many times these patients that fall into the 9% might not be experiencing their symptoms due to the crystals in their inner ear, but from a central cause where the brain or brainstem is not interpreting and responding to signals appropriately. With a thorough neurological examination by trained professionals, the underlying cause of these ongoing symptoms can be detected and an alternative, non-invasive treatment strategy can be prescribed to overcome BPPV. At Georgia Chiropractic Neurology Center, we do just that. Our team uses technology for assessing vestibular deficits and then conducts an advanced neurological examination to find what may be getting overlooked in other settings.

We start with diagnostics, including video oculography and a computerized assessment of postural stability, or CAPS. Video oculography, or VOG, measures eye movements and detects abnormalities that are related to different areas of the brain. The CAPS unit is used to measure stability on both hard and foam surfaces in different head and eye positions. This picks up any sway patterns and degrees of movement to provide the doctors with information regarding your imbalance. After diagnostics, our doctors will perform an examination that looks at how the brain is taking in and processing information and then how the brain’s output is affected. Once the underlying cause is determined, a treatment plan is created tailored to your specific needs.

These 9% cases are difficult and can also become discouraging for individuals experiencing these ongoing symptoms, but with a proper examination and plan relief is possible.

1. Nunez R. A., Cass S. P., Furman J. M. Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2000;122:647–652.[PubMed]