Benign Paroxysmal Positional Vertigo (BPPV)

BPPV's complete form is Benign Paroxysmal Positional Vertigo, which commonly occurs due to inner ear problems or moving your head in a specific position. It is also called dizziness-positional, vertigo-positional, or Benign positional Vertigo. Benign positional Vertigo is the most common type of vertigo. Sometimes you feel that everything around you is spinning, or you are spinning in this situation called vertigo. A specialized procedure called the Epley manoeuvre is used to treat BPPV. Mostly, BPPV doesn’t need any medication unless the patient has extreme nausea or vomiting.

BPPV Causes

BPPV is most commonly caused by inner ear problems. The inner ear has semicircular canals that are filled with fluid. The canals are very sensitive to the movement of the fluid. If you move, the fluids move inside the canals. This moving fluid helps you keep balance, as the brain gets signals about the position of the body from the sensations of fluid moving inside the tube.

Utricle is a sensory organ inside the ear. When otoconia a tiny calcium crystal, is misplaced from its regular location in the utricle then BPPV occurs. Detached crystals move fluid inside the ear and the semicircular canal (SCC), and it looks like the head is moving. These crystals drift into the posterior SCC, making their orientation at the lower part of the inner ear comparable to gravity.

When a person changes his position, such as from looking downward to upward, from lying to sitting, or rolling over, otoconia will cause a problem. It will move otoconia to the lowest canal, and then fluid will flow inside the SCC, which stimulates the balance, causing jumping eyes and vertigo. 

Positional Vertigo can be caused by:

• Mild to extreme head trauma.
• Keeping the head in the same position for a long time
• Vigorous Aerobics
• Riding a Bike on Rough Trails

BPPV Symptoms

Positional dizziness includes any of the following symptoms:

• If you change the position of your head, you will feel it spinning or moving.
• You will lose your balance while walking, getting up from bed, or tilting your head forward and backwards.
• You can feel quite ill with vomiting and nausea.
• Likewise, you can have a vision problem and feel that things are moving or jumping around you.
• You may even have hearing problems.

Diagnosing BPPV

A physical exam from your doctor is necessary to diagnose BPPV, which is called the Dix-Hallpike maneuver. 

Dix-Hallpike maneuver 

In this test, your doctor will move your head 45 degrees to one side. Then you will be asked to quickly lie down backwards over an examination table. This movement will create vertigo, and your doctor will see an abnormal movement of your eyes called nystagmus. If the response is positive, it means you have BPPV. 

BPPV Treatment

For the treatment of BPPV, we do not need any tests, pills, surgery, or medicine. It can be treated by vertigo exercises such as the Epley maneuver and balance therapy.

In the Epley maneuver, Your doctor moves your head in a special pattern. It will help Crystal move out of SCC. Several repositioning maneuvres performed may be needed during the same visit.

After the Epley maneuver , you may begin walking, but with caution. You should avoid bending your head far forward (for example, to tie shoes) or putting the head back and sleeping on the side of the affected ear. Other exercises that you can do at home may help, but they can take longer to work.