I finally realized that I had HC BPPV last month, and that’s why the Epley’s maneuvers I was doing weren’t clearing it.  I have distinctly different symptoms when my horizontal canal (HC) is involved.  Standard-issue posterior canal BPPV gives me the feeling of motion when I am not moving, it gives me sustained nystagmus, I have trouble lying and rolling in bed, and I have trouble looking up & down and “combo” moves like down and back.  Horizontal canal BPPV, on the other hand, gives me a feeling of constant nausea (usually persisting even when I am still and lasting all day), it gives me almost no nystagmus, I experience oscillopsia and walk around squinting, and although I can look up and down with no trouble, I can’t look side to side (especially with any velocity).  Even smaller, subtler head movements like those made during conversation and gently washing my face trigger it.  (In the latter case, bending over to wash my face will be a trigger if I have posterior canal, but the actual washing is the trigger with horizontal canal.)

As I was doing Epley’s last month, I was often negative on the DHP and got nystagmus only when I moved from the first position to the second position.  I realized the motion was similar to the Supine Roll Test, which is used to test for HC BPPV.  Sure enough, when I did the SRT, I was positive.  This explained the vague unsteadiness I was experiencing every day.  I wasn’t sure how to clear HC at home, so I made an appointment with my vestibular physical therapist.  As I waited for my appointment to roll around, I was late to work twice due to flare ups.  The first was mostly HC, and once I got to work I could make it through the nauseating day.  The second flare up was more of a posterior canal manifestation and was actually the strongest nystagmus I’ve had for a month or more.  Of course, two days later when I saw my PT, I was negative on every test she did!  I believe that last flare up was a result of my converting the HC to PC, which I then easily cleared at home.

And that second flare up was caused by yoga.  Although I did a class with (an approximate) downward facing dog the week before, this time I think I went a little too far with my head.  In any case, I was down on all fours on the yoga mat as the room tilted.  I self-treated right there on my mat, but I was self-conscious and didn’t get the third position right.  I continued with class but was unsteady with movement of any kind.  No more down dogs, no bends of any degree.  I realized I wouldn’t be able to drive home if I didn’t treat again, so I did and then sat against the wall with my feet flat on the floor for the rest of class.  I must not have gotten that third position right the second time either, because I had to have a classmate drive me home while my wife had a neighbor drive her to the yoga studio to pick up our car.  At home I did the Epley’s a third time, this time really getting in the third position, and that set me on the road to recovery.  I felt very sick getting into bed, but after sleeping up on two pillows and avoiding the “dizzy side,” I woke with the problem resolved.

So, I learned a few things:

  • My vestibular physical therapist taught me how I can clear HC at home
  • I crystallized my understanding of the differences in my HC and PC symptoms
  • I have more data about what I can and cannot do in yoga
  • I realize that if HC persists, I may be able to convert it to PC and then clear it.  (Don’t try this at home!  You could get canal jam!)

You might enjoy reading Yoga – heart version.