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Home 9 Conditions Treated 9 Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV)

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About Benign Paroxysmal Positional Vertigo (BPPV)

What Is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) is a common disorder of the inner ear that leads to recurring episodes of dizziness or vertigo. It occurs when small calcium crystals called otoconia become dislodged from their usual position within the inner ear and migrate into the fluid-filled canals responsible for sensing head movement. This displacement can interfere with the normal movement of fluid in the inner ear, causing a false sense of spinning or rotational movement.

Benign Paroxysmal Positional Vertigo Diagnosis

How Do We Diagnose BPPV ?

Diagnosing BPPV typically involves a comprehensive evaluation of a person’s medical history and a physical examination by a healthcare professional, often vestibular physiotherapist/headache practitioner. The healthcare provider may conduct specific tests, such as the Dix-Hallpike manoeuvre or the Roll Test, to provoke and observe the characteristic vertigo and nystagmus (involuntary eye movements) associated with BPPV. Additional tests like audiometry or imaging studies may be performed to rule out other possible causes of the symptoms.

BPPV Symptoms

Vertigo

Recurrent episodes of Vertigo

Triggered by changes in head position, such as rolling over in bed, looking up or down, or bending over

Dizziness

Imbalance

Lightheadedness

Typically brief episodes but intense, lasting for a few seconds to a few minutes.

Nausea

 

 

NOTE: Symptoms can vary in frequency and intensity from person to person, and they may come and go over time.

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Treating Benign Paroxysmal Positional Vertigo

BPPV Treatment

The treatment of BPPV aims to reposition the displaced calcium crystals within the inner ear to their normal location and alleviate the associated symptoms. This can often be achieved through a series of specific head movements known as canalith repositioning procedures or particle repositioning maneuvers. The most widely known and effective maneuver is the Epley maneuver, which involves a sequence of head and body movements designed to guide the dislodged crystals out of the affected canal and into an area where they will no longer cause symptoms. Healthcare professionals may also teach patients self-treatment techniques to perform at home.

In cases where canalith repositioning procedures do not provide sufficient relief, or if BPPV recurs frequently, medication may be prescribed to help alleviate the symptoms. Medications such as vestibular suppressants, antihistamines, or anti-nausea drugs may be used to manage vertigo and associated symptoms on a temporary basis.

It’s important to note that BPPV is generally a benign condition, and while it can be bothersome and disruptive, it does not typically lead to serious complications or permanent damage to the inner ear. Seeking medical evaluation and appropriate treatment can help individuals effectively manage and reduce the impact of BPPV on their daily lives.

 

For further reading about BPPV, read our blog here

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Benign Paroxysmal Positional Vertigo – Frequently Asked Questions

What is BPPV?

BPPV, or Benign Paroxysmal Positional Vertigo, is a common inner ear disorder that causes brief episodes of dizziness or vertigo triggered by changes in head position. It occurs when tiny calcium crystals in the inner ear become dislodged and disrupt balance signals.

What are the symptoms of BPPV?

Symptoms include sudden, brief episodes of vertigo (a spinning sensation), nausea, imbalance, and sometimes nystagmus (involuntary eye movements). These symptoms are often triggered by movements like lying down, turning over in bed, or looking up.

What causes BPPV?

BPPV is caused by the displacement of calcium carbonate crystals (otoconia) in the inner ear. It can occur due to ageing, head trauma, ear infections, or without any identifiable cause (idiopathic).

Who is at risk of developing BPPV?

BPPV is more common in older adults, particularly those over 50. Risk factors include head injuries, prolonged bed rest, and certain inner ear conditions.

How is BPPV diagnosed?

BPPV is diagnosed through a clinical evaluation, including a detailed medical history and physical examination. The Dix-Hallpike manoeuvre is a common test used to confirm the diagnosis by reproducing vertigo and observing nystagmus.

Infrared goggles are helpful to detect the involuntary eye movements called nystagmus.

What are the common triggers for BPPV?

Triggers include sudden head movements, lying down, rolling over in bed, or tilting the head backward or forward. These movements can dislodge the inner ear crystals, causing vertigo.

How is BPPV treated?

BPPV is often treated with repositioning manoeuvres, such as the Epley manoeuvre, which guide the dislodged crystals back to their proper location in the inner ear. In rare cases, surgery may be considered if symptoms persist.

Can BPPV go away on its own?

Yes, BPPV can resolve on its own as the crystals naturally settle back into place. However, treatment with repositioning manoeuvres can provide faster relief and reduce the risk of recurrence.

Is BPPV a serious condition?

While BPPV is not life-threatening, it can significantly impact quality of life by causing dizziness, imbalance, and an increased risk of falls. Prompt diagnosis and treatment are important to manage symptoms effectively.

When should I see a doctor for BPPV?

See a doctor, headache practitioner or vestibular physiotherapist if you experience recurrent or severe vertigo, dizziness, or imbalance that affects your daily activities. Immediate medical attention is necessary if vertigo is accompanied by symptoms like severe headache, double vision, or difficulty speaking, as these may indicate a more serious condition.

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