Benign paroxysmal positional vertigo (BPPV)

Symptoms & causes Diagnosis & treatment Doctors & departments Care at Vejthani

Overview

One of the most common causes of vertigo — the sudden sensation that you’re spinning or that the interior of your head is spinning — is Benign Paroxysmal Positional Vertigo (BPPV).
BPPV causes short bursts of mild to severe dizziness. It is frequently induced by certain changes in the position of your head. This can happen when you tilt your head up or down, lie down, or turn over or sit up in bed.
Although BPPV might be annoying, it is rarely dangerous unless it raises the risk of falling. BPPV can be effectively treated at a doctor’s office visit.

Symptoms

BPPV signs and symptoms may consist of:

Dizziness
Nausea or vomiting
Vertigo – the sensation that you or everything around you is spinning
Unsteady gait or lack of balance

The symptoms of BPPV come and go and usually last less than a minute. BPPV episodes can disappear for a while and then reappear. Symptoms of benign paroxysmal positional vertigo are frequently accompanied by abnormal rhythmic eye movements.

Activities that cause BPPV symptoms differ from person to person, but are virtually always triggered by a shift in head position. When standing or walking, some people feel unbalanced.

Consult your doctor if you have recurring, sudden, severe, or protracted dizziness or vertigo.

Although dizziness seldom indicates a serious illness, call for emergency help promptly if you have dizziness or vertigo combined with any of the following symptoms:

Sudden or severe headache
Fainting
Falling
Walking problem
Weakness of the arms and legs
Numbness
Tingling
Fever
Vision problem (e.g., double vision or not being able to see)
Lightheadedness
Hearing loss
Speech problem

The above-mentioned signs and symptoms may indicate a more serious condition

Causes

When a cause of BPPV is identified, BPPV is frequently connected with a slight to severe trauma to the head. Less common causes of BPPV include inner ear diseases or, in rare cases, damage caused by ear surgery or long durations positioned on your back, such as in a dentist chair. BPPV has also been linked to migraines.

There is frequently no known cause of BPPV. This is known as idiopathic BPPV.

Ear function

The vestibular labyrinth is a small organ located inside your ear. It consists of three loop-shaped structures (semicircular canals) that hold fluid and fine, hairlike sensors that track the rotation of your head.

Otolith organs, Other structures in your ear, detect your head’s movements — up and down, right and left, back and forth — as well as your head’s location in relation to gravity. These otolith organs contain crystals that make you gravitationally sensitive.

These crystals might get dislodged for a variety of reasons. They can move into one of the semicircular canals when they become dislodged, especially if you’re lying down. This causes the semicircular canal to become sensitive to changes in head position that it would typically not respond to, which causes dizziness.

Risk factors

Benign paroxysmal positional vertigo is most common in adults over the age of 50, but it can occur at any age. BPPV is also more prevalent in women than men. A head injury or any other condition of your ear’s balance organs may make you more vulnerable to BPPV.

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Diagnosis

A variety of tests may be performed by your doctor to establish the reason of your dizziness. Your doctor will most likely look for the following during a physical exam:

Experiencing dizziness during particular eye movements while lying on your back, with your head turned to one side and slightly tilted over the edge of the examination bed.
Dizziness sensations that are triggered by eye or head movements and then subside in less than one minute
Lack of control over the movement of your eyes
Involuntary side-to-side eye movements

If your doctor is unable to identify the source of your symptoms, he or she may prescribe more tests, such as:

Electronystagmography (ENG) or Videonystagmography (VNG). These tests are designed to detect abnormal eye movement. By measuring involuntary eye movements when your head is put in different postures or your balancing organs are stimulated with water or air, ENG (which uses electrodes) or VNG (which uses small cameras) might assist to determine if dizziness is caused by inner ear disorders.
Magnetic Resonance Imaging (MRI). A magnetic field and radio waves are used in this test to make cross-sectional images of your head and body. These photos can be used by your doctor to identify and diagnose a variety of illnesses. An MRI may be used to rule out other potential causes of vertigo.

Treatment

Benign paroxysmal positional vertigo may resolve on its own after a few weeks or months. However, to help eliminate BPPV sooner, your doctor, audiologist, or physical therapist may treat you with a series of motions known as the canalith repositioning technique.

Canalith repositioning procedure

The canalith repositioning technique, which is done in your doctor’s office, consists of a series of physical movements to position your head. The idea is to transport particles from your inner ear’s fluid-filled semicircular canals into a little baglike open space (vestibule) that houses one of your otolith organs, where they won’t create problems and are more easily resorbed

After any symptoms or odd eye movements have stopped, each posture is kept for approximately 30 seconds. After one or two sessions, this method usually works.

Your doctor will almost certainly educate you how to execute the procedure on yourself so that you can perform it at home if necessary.

Surgery

When the canalith repositioning treatment fails, your doctor may propose surgery. A bone plug is utilized in this surgery to obstruct the area of your inner ear causing dizziness. The stopper inhibits the semicircular canal in your ear from responding to particle movements or head movements in general. Approximately 90% of canal plugging surgeries result in successful outcomes.