Canalith Repositioning Chairs
Dr. Purcell has been treating BPPV patients with his canalith repostioning chairs for over ten years. He has remained dedicated to resolving patient's vertigo while also working to continually improve the technology of the canalith repositioning chair. He is currently formulating a comprehensive analysis of the nystagmus patterns observed in different canalithiasis and cupulothiasis scenarios for scientific publication. He is also performing research of dual camera acquisition for accurate measurement of three-dimensional eye movements.
BPPV is diagnosed by looking for abnormal eye movements called nystagmus, which are recorded in our office with infrared video oculography while the patient is positioned on our canalith repositioning chair. There is a reflex pathway from the hair cells in the inner ear and the muscles around the eyes. We can infer which ear and which canal is being irritated by watching eye movements with your head placed in positions that may exacerbate symptoms (i.e. Dix-Hallpike Maneuver). The treatment protocol is decided after studying these eye movements.
Treatment of BPPV involves placing your head and body in certain positions to “roll the crystals out of the canal” and back into the area where they came from (the vestibule). These maneuvers are called canalith repositioning maneuvers such as the Epley maneuver. After treatment, we record your eye movements again in the same head position that had previously caused symptoms of vertigo. If the eye movements resolve and your symptoms have markedly improved, the BPPV has been treated.
The canalith repositioning chairs allow for more accurate data acquisition when compared to the classic table Dix-Hallpike maneuver. Rather than just rotating the patient's head, we are able to fully maneuver the body with little discomfort or effort from the patient.
After treatment on one of the canalith repositioning chairs, the patient may experience a lingering disequilibrium for 2-3 days. It will take time for the crystals to settle back into the vestibule, and for that reason we would like you to avoid certain positions until your follow-up appointment. For 7-10 days you should avoid the following:
Do not lie down completely flat on your back. Have your head elevated at least 30-45 degrees.Sleep with at least two pillows behind your head.
Avoid activities that require lying flat (i.e. dentist, chiropractor, massage).
Keep your head above the level of your heart.
Do not perform movements such as bending forward or looking underneath the kitchen sink.
Avoid activities such as feeding small pets, picking up small children.
Try to bend with your knees rather than bend forward at the hip
To learn more about the clinical practice guidelines for benign paroxysmal positional vertigo, click the following link: