Recurring vertigo, triggered by specific body movements - ideas on next steps?
I’ve been dealing with imbalance, dizziness, and vertigo spells since 2016. A teaching doctor at the local university/audiology lab diagnosed a right labyrinthine dysfunction from RCT and VEMP testing, with no additional peripheral or central vestibular pathology. DHP testing suggested concomitant possible BPPV. I’ve had multiple rounds of vestibular therapy since then. My PT also suggested there might be a vestibular migraine component, and/or food sensitivities.
In the past 1.5 years I’ve predominantly experienced recurring vertigo spells (yes, the room spins). I’m sensitive to fluorescent/LED lights, and loud/ongoing noise. I’ve finally started experimenting with the removal of certain foods, to see if there are any sensitivities (hours or next day(s)).
I’m often in a crouching/leaning forward position right before the vertigo episode. Think of crouching down to pull weeds, then leaning further forward to grab another weed. Then getting up, walking, and crouching down again. Another trigger is leaning into a car to vacuum it out. Vertigo will hit out of nowhere. Rarely, I can feel it coming on, roll back my head (look up), sit on my butt, and ‘short-circuit’ or calm it temporarily. Usually the spinning begins and I have to lie back or down for awhile (the spin lasts minutes, sometimes 30; the longest 3 hours). Sometimes looking down (like at your phone or papers on a desk) will trigger a milder ‘off’/imbalance feeling. Since Covid has gotten worse, I don’t even call or go to my PT. I do my hallpike diagnostics, and an epley for whichever side seems to indicate spinning. Afterwards I usually I still feel ‘off’ or that my head feels slightly ‘disconnected.'
My QUESTION… Is it possible there’s an escaped otolith (ear crystal) from one of the canals, that the epley maneuver doesn’t resolve? Is it possible an otolith has never gotten back to where it needs to be? I remember my PT telling me any stray otoliths will break down and be absorbed by the body, but I really wonder how much of that is true. I gather science still has much to learn about inner ear disorders and vertigo. My point is, isn't it strange a specific set of body movements (described above) are involved right before almost all of my vertigo spells anymore? It’s not 100% of the time, but I’d argue 75%.
Ideas? Thoughts? Next steps?