What should I pay attention to after otolithiasis repositioning?

Author: Hoshili

Unit: Binzhou Second People's Hospital

Many people have had this experience: when turning over in sleep or getting up, they suddenly experience severe vertigo, the world is spinning, and severe cases are accompanied by nausea and vomiting. This may be caused by otolithiasis. Otolithiasis, also known as benign paroxysmal positional vertigo, refers to short-term paroxysmal attacks of vertigo and nystagmus that occur when the head moves rapidly to a certain head position. Under normal circumstances, otoliths are attached to the otolith membrane. When some pathogenic factors cause the otoliths to detach, these detached otoliths will swim in the fluid called endolymph in the inner ear. When the human head position changes, these semicircular canals also change position. The submerged otoliths will move with the flow of the fluid, thereby stimulating the semicircular canal hair cells, causing the body to experience severe vertigo, which is generally short-lived, from a few seconds to a few minutes. The best treatment for otolithiasis is repositioning therapy. Most patients only need one or two repositionings to fully return to normal.

Many patients with otolithiasis still feel dizzy after repositioning treatment, or are very cautious, fearing that the stone will fall out again, so they keep calling for consultation. So what should we pay attention to after repositioning?

1. Do not walk around immediately after the reduction, let alone drive a vehicle. It is best to sit and rest for half an hour before walking around.

2. After the horizontal semicircular canal is relocated, you should avoid lying on the affected side for about a week. If the stone is in the left ear, you should lie on the right side when sleeping, and do not turn to the left side. It is recommended to raise the head of the bed by about 30 degrees within 3 to 5 days of relocation treatment. If it is not a hand-cranked bed, you can fold the quilt, put a pillow on the quilt, and set a slope of about 30 degrees.

3. Within 2-3 days after reduction, you should move slowly when lying down, getting up or turning over. Do not do strenuous exercise, especially shaking your head, jumping, etc. Try to avoid head injuries and do not have teeth pulled, etc. Otherwise, the vibration of the head can easily induce the otoliths to fall off, causing vertigo to occur again.

4. Develop good living and eating habits. Ensure adequate sleep, avoid staying up late or overwork, pay attention to daily light diet, avoid eating too spicy and irritating food, avoid smoking, drinking alcohol, strong tea, etc.

5. Many patients still feel top-heavy, with floating feet and stiff neck after repositioning. This is because the vestibular function has not yet fully recovered. Don't be nervous. You can take oral medications such as Mindray, ensure sleep, and walk appropriately, which will help the vestibular function recover as soon as possible. You can also walk in a "one" step or practice Tai Chi and other activities to strengthen vestibular rehabilitation exercises.

6. Can I reset my otolithiasis at home by myself? Otolithiasis, also known as benign paroxysmal positional vertigo, is generally not life-threatening. Once a patient becomes ill, he or she should go to a specialist doctor who has experience in treating vertigo for diagnosis and treatment. The manual resetting of otolithiasis may seem simple, but it must be performed by a professional doctor. Self-resetting by patients or non-professionals often does not achieve the desired effect, and may even backfire and aggravate the condition. If the patient has serious problems with the cervical spine, blind resetting may be dangerous. Finally, if the symptoms are not relieved for a long time, you must return to the hospital for a follow-up visit in a timely manner, and if necessary, do a cranial MRI and cerebral vascular ultrasound examination to rule out intracranial space-occupying and cerebrovascular lesions.