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Benign Paroxysmal Positional Vertigo

Here at Functional Physiotherapy, we can treat Benign Paroxysmal Positional Vertigo:

So, what exactly does BPPV mean? Let’s break it down.

Benign: the cause is not cancerous, harmful, or life-threatening



Paroxysmal: it comes in sudden, brief episodes



Positional: it gets triggered by certain head positions or movements



Vertigo: a false sensation of motion often reported as a spinning sensation

BPPV is a disorder of the part of the inner ear that communicates with the brain and controls balance and eye movements.

So, what’s happening in the inner ear to cause this spinning or vertigo?

Some of the calcium carbonate crystals (otoconia) normally embedded in gel in the utricle of the inner ear become dislodged and migrate into one or more of the three fluid-filled semi-circular canals. When enough of these particles accumulate in one of the canals, they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.

How do we diagnose BPPV?

We will diagnose BPPV by taking a thorough history of your symptoms, along with performing a test called the Dix-Hallpike test. This is a positional test that we will complete on the assessment. The test aims to accurately diagnose BPPV by reproducing your symptoms. While this might be unpleasant at the time, it is good to have a positive test, as BPPV can be treated very effectively.

If we do not find that BPPV is the cause of your vertigo, we will refer you to your GP or specialist.

Symptoms of BPPV

• Vertigo (spinning sensation of yourself or the environment)
• Rhythmical, repetitive, and involuntary movement of the eyes
• Dizziness
• Imbalance
• Nausea
• Vomiting

How do we treat BPPV

To treat BPPV, we will determine in which one of the three canals of the inner ear the particles are floating. We will then apply a re-positioning manoeuvre (Epley or Simont) specific to that canal to return the crystals to a position where they do not cause problems.

The most common type of BPPV involves loose crystals moving freely in the ear’s fluid canal (Canalithiasis) and the second type is crystals clinging to the bundle of nerves responsible for fluid movement (Cupulolithiasis).

In general, the success rate of treatment is between 70-90%. Usually, one or two treatments are enough.

BPPV may follow

• Head trauma
• Vestibular neuritis (previously known as labyrinthitis)
• Unusual head positions
• Bed rest
• Exposure to continuous jarring
• Idiopathic (unknown cause)

Although it is not common for vertigo to be a serious condition, please seek immediate medical help if you experience any of the following along with vertigo.

• A new, different, or severe headache
• A fever
• Double vision or loss of vision
• Hearing loss
• Trouble speaking
• Leg or arm weakness
• Loss of consciousness
• Falling or difficulty walking
• Numbness or tingling
• Anxiety disorders with or without panic

BPPV is a common condition affecting up to 64 in 100,000 people. It usually affects people between the ages of 50 and 70 with women being affected twice as often as men.

If you have suffered a sudden onset of vertigo related to a change in position such as rolling over in bed, bending over, or looking up, then register here to book a 60-minute appointment with Jo.