We now have many variations of canalith repositioning. Otolaryngology - Head and Neck Surgery, 107(3), Epley JM, The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo, 399–404, Copyright Elsevier 1992 I faced a small sample of that same skepticism and criticism when I started performing CRP in the early nineties. He was aware, but unfazed by the critics. I made a point to sit with him at lunch at the course in Denver. Epley’s path to acceptance and recognition of his maneuver was not an easy one. John Epley developed the less strenuous, and now famous, Epley maneuver, and introduced it to the United States.Īfter my friend came back cured from Johns Hopkins, I booked a flight to Dr. Then a couple of French researchers (most notably Alain Semont) modified the B-D exercises into a single treatment procedure and published impressive results of rapid symptom resolution. I mention this because the head movements in the B-D exercises are not particularly effective at repositioning otoconia from the canal to the vestibule. When patients started getting better in a couple of days, they knew they were on to something, and suspected “dispersion of otolithic debris from the cupula.” Brand-Daroff developed exercises based on the idea of habituating the response to repeated provocation. Practitioners beginning their career after 1990 might enjoy a quick review of the road to repositioning. A Brief History of Canalith Repositioning (CRP) for BPPV I was so curious about this magic treatment that it changed the course of my career. She came back the next week having been immediately “cured.” I didn’t really know what to do for her, so I sent her to Johns Hopkins (about six hours away). She was an educated, athletic, affluent person, and the episodes were really impacting her life. My first exposure came when a personal friend came to my office with complaints of recurrent vertigo. It is difficult now to imagine that when I first started practicing in the early 80s, canalith repositioning (CRP) techniques for BPPV did not exist. Yes, I am paraphrasing Jay Z to discuss effective treatment of Benign Paroxysmal Positional Vertigo – or BPPV for short.
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