Thanks to your informative video, I have cured some patients with BPPV and recognized many patients with posterior circulation stroke.
@tonyf315
4 жыл бұрын
Another gem that I'll be using as a teaching resource for my vestibular special interest group in our rehab department! Thanks!
@ericandrius
3 жыл бұрын
You're such a good teacher!! A inspiration for a neurologist in formation. Keep posting, please!
@heartsnacks
4 жыл бұрын
Keep these coming Dr. Johns, this is so helpful!
@germinalmc
4 жыл бұрын
Super informative video peter great job, how long do you recommend patients to reinstate a normal life (exercise and driving) after epley or gufoni maneuver, i get asked that a lot but have no definitive answer
@PeterJohns
4 жыл бұрын
I don't know of any supportive studies on this. But if the repeat DHT and SRT is negative after an Epley or Gufoni I would probably say if they can drive. But if they are getting dizzy to any significant degree, they shouldn't. Canada isn't as litigious as our neighbours to the south, so answers might be different depending on where you practice.
@harishchandergoel5159
2 жыл бұрын
Nice👍
@cs5875
4 жыл бұрын
Hi Dr Johns, im 31 and i had BPPV, went to an ENT and they did the DH maneuver on the right and induced vertigo with nystagmus, my eyes were going a bit to the ceiling with and to the left they concluded it is posterior and they did the epley and told me not to move my head and sleep elevated for 2 days and then do the Brandt Darroff excersise daily, 2 days past i still have some mild dizziness. My question is, can i do the DH maneuver too see if it went well ? Should i do the Brandt Daroff (i searched and new research shows its not effective and others say to do it after 1 week) Also is it normal to have BPPV at 31? Didnt have any traumas just got up fast from the bed a couple of times to check the time the night when it started.
@PeterJohns
4 жыл бұрын
I will answer in general terms, as I don't like commenting on particular patients problems. Mild dizziness post maneuver is quite common and often settles down in a few days. Performing another DH test to see if symptoms have resolved is commonly done to judge whether the Epley was effective. Brandt Daroff exercises are less effective than repeating Epley maneuver if the repeat DH test still shows vertigo and nystagmus characteristic of posterior canal BPPV. BPPV is seen in all ages, including children, although much more common is older patients.
@cs5875
4 жыл бұрын
@@PeterJohns Thank you very much for the fast reply, if after 2 days of Epley there is no more nystagmus but occasional mild dizziness should the Brandt Darroff exercise be done (even if it brings moderate dizziness after) or should the patient just live as usual and the dizziness will disappear by itself with time?
@PeterJohns
4 жыл бұрын
@@cs5875 I would say the later is more appropriate. I haven't ever told a patient to do the Brandt Daroff exercise.
@aragonthebrave
4 жыл бұрын
Sir...has it ever happened to you that despite doing gufonis manoeuvre, the patients nystagmus or giddiness has not reduced??I got patients recently....whom I felt like horizontal canal bppv and though the giddiness had reduced...but it did not completely go away
@PeterJohns
4 жыл бұрын
Yes, I generally find HC BPPV a little harder to clear. Just had a apogeo HC BPPV, which after the Gufoni converted to a geotropic HC BPPV, the after the Gufoni for that converted to a PC BPPV, which then took two Epley to clear. If the patient still feels slight dizzy but no nystagmus is seen on repeat testing, I usually discharge them, and ask them to return if they have repeated episodes of the significant vertigo like the kind that brought them to me in the first place.
@Ihsaan1c
4 жыл бұрын
Dr Johns, if I perform an Epley procedure and on follow up, the patient has no symptoms, is there any value in repeating the DH or Epley? Could it cause any problems? Thank you.
@PeterJohns
4 жыл бұрын
You mean on a different day? If so, I wouldn't do anything in terms of positional testing if they don't get dizzy getting in, out or turning over in bed. If you mean 15 minutes after having their first Epley, I always re-test them to see if it worked. If it didn't, I repeat it.
@Ihsaan1c
4 жыл бұрын
Peter Johns Thanks, yes I mean on a different day, their follow up appointment with me a few weeks after their epley procedure.
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