Just like frozen shoulder occurs in stages (freezing, frozen and thawing), I believe some forms of BPPV occur in stages. Stages for some forms of BPPV seem to be dumping, dumped and recovery. Based upon what I see in the clinic, timing of when clients receive repositioning treatments seems to impact the success of the maneuvers for some individuals. I believe some forms of BPPV suddenly occur. In other words, if 100,000 pieces of otoconia are going to fall out, they all fall out at once. These clients seem to reposition fairly easily. I believe there are others who dump a few thousand out every day or week for a period of time. If we try to reposition otoconia when the person is in the dumping phase, we will need to continue repositioning periodically until the client reaches the dumped or recovery phase. I believe the dumping stage represents BPPV at an unstable level.
Many forms of vestibular dysfunction seem to occur in stages. Depending upon whether or not vestibular rehab works will depend upon which stage the individual is in.