Canolith Repositioning Maneuver for Vertigo

Vertigo is disabling vestibular disorder that is characterized by extreme bouts of dizziness and nausea, often with no relief from conventional treatments such as drugs and surgery. There are several different types of vertigo, so it is important for the doctor to determine the cause so that the correct treatment can be used. Your doctor will perform a series of simple tests to help determine the cause and also rule out potentially life-threatening disorders. You should also be prepared to give a brief history of your illness, including any recent traumas. Chiropractors have always had great success treating cervicogenic vertigo, which literally means to originate from the cervical spine or neck. Usually an adjustment to the upper cervical area offers the patient great relief from this type of vertigo. But there is another form called benign paroxysmal positional vertigo (BPPV) that has a different cause. In BPPV, dizziness and other symptoms with certain head movements is due to debris (small crystals of calcium carbonate, also referred to as a “canalith”) which has detached from the utricle in the vestibule of the inner ear and has collected within a part of the inner ear. The goal of canalith repositioning procedure (CRP) is to move the displaced debris out of one of the semicircular canals so that they don't send false signals to the brain about spatial movement. Through a series of head position changes, the CRP moves the canaliths from the canal to the utricle. Once in the utricle, the canaliths may re-adhere to the otolithic membrane, dissolve, be broken up, or move some place where they can't cause symptoms.

These maneuvers involve a series of specifically patterned head and trunk movements performed by a trained professional who closely watches eye movements with each position change. CRP can be performed in the doctor's office and the entire procedure that takes about 15 minutes to accomplish. Precautions are provided for the days immediately following the procedure in order to ensure that the canaliths don't have the opportunity to return to their formerly problematic location in one of the semi-circular canals.
 
CRP is very effective, with an approximate cure rate of 80%. The recurrence rate for BPPV after these maneuvers is low. However, in some instances additional treatment(s) may be necessary. It is important to schedule these appointments ahead of time and be prepared to have transportation home in case there is some lingering dizziness.

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