Vertigo, BPPV

Vertigo can be more severe than dizziness, and is characterised by the sensation that you, or the environment around you, is moving or spinning.

One cause of dizziness or vertigo, is known as Benign Positional Paroximal Vertigo (BPPV).
There are other causes of dizziness, including heat disease, high blood pressure, neck problems, and aging.  The most severe causes for vertigo could also include strokes, trauma, and types of cancer — so if you or a family member suffer from vertigo, get it checked by a doctor. Please see my other page — on Dizziness for more information about this.

Benign paroxysmal positional vertigo (BPPV) can result from (even minor) head injury, or simply occur in older people.  As many as 50% of those over 65 year may experience some BPPV. 

Other conditions related to BPPV, as balance disorders, include labyrinthitis (vestibular neuritis) and Ménière's distease.  Ménière's disease (which may be frequently over-diagnosed) is characterised by vertigo, tinnitus (ringing in the ears) and hearing loss.  There is usually no hearing loss (other than from aging) with BPPV, only episodes of vertigo, caused by changes in head position. 

BPPV is one of the most common causes of vertigo.  BPPV is triggered by particular changes in head position, such as moving the head up or down. It's not usually serious, unless it increases the risk of falling.  People can experience a sense of dizziness, a spinning sensation (vertigo), lightheadedness, unsteadiness, loss of balance and nausea. 

A diagnosis of BPPV is made using the Dix-Hallpike test when it produces nystagmus (a specific movement pattern in the eyes).

Show video: The Dix Hallpike test for BPPV

Different types of nystagmus can show which of the semi-circular canals is affected and which variant of of BPPV is occurring (posterior, lateral, or superior canal BPPV). The different types of nystagmus are shown here, on this representation of the Dix-Hallpike test.

Show video: Dix Hallpike to Diagnose BPPV Dizziness

Other possible causes of vertigo (including the central nervous system) need to be ruled out, when making a diagnosis of BPPV.

Treatment can be very helpful for BPPV, and is usually very effective when performed correctly.  This mainly consists of determining what type of BPPV you may have, and on which side (and which of the semi-circular canals in the inner ear may be involved). 

Treatment often involves the use of the Epley maneuver and includes a series of head movements that shift the particle or crystal in the affected semi-circular canal in the inner ear.

Show video: Epley Maneuver to Treat BPPV Vertigo

The best person to see for treatment for BPPV, after seeing your GP (do this for any kind of vertigo) will be a specialist: neurologist, vesbiluar physiotherapist, or osteopath who has had training in this area.

 

 

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