Author: Laura Gonzalez Jamison
Is your room spinning?
BPPV may be the culprit.
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. This type of vertigo is characterized by a brief episode of mild to intense spinning sensation that can last from 15 to 30 seconds. Usually is a sensation exacerbated by specific head or body movement such as turning to the side, tilting the head back (hairdresser position), bending over, rolling/turning or lying down in bed. Basically any sudden change in position can trigger the symptoms.
Other symptoms may include nausea/vomiting, light-headedness sensation, loss of balance and blurred vision. The trigger activities or movements can vary from person to person.
What can cause BPPV?
More than the 50% of the cases are from unknown reason or etiology. However some known causes for BPPV are: a head injury, a prolonged time in a supine position, a degeneration of the balance system or viruses that have affected the inner ear.
What is physically happening?
Our inner ear has a vestibule and three semi-circular canals filled with fluid. In the vestibule we can find the otoconias, what is often referred as “crystals” or “ear stones”. These calcium made “crystals” can get dislodge and can move to the semi-circular canal altering the fluid movement with every movement and at the same time movement perception. You can see an animation of the process at this link: click here.
Let’s make it simple. Think about a glass filled with water and some stones in it. Now if you turned it up-side down, gravity will act on the stones and they will move from top to bottom taking a few seconds for them to settled again. Same thing happens in your ear, every time you move your head the stones will move, will send a false message to the brain and will cause vertigo for few seconds until they settle. The spinning sensation will stop until your move your head again and the same activity occurs again.
How it is diagnosed?
BPPV is diagnosed by a positional test called the Dix-Hall pike. During this test the physician or the audiologist is looking for a characteristic rotatory eye movement (torsional nystagmus) that allows a proper diagnosis. This is a classic response and movement when the affected ear is stimulated.
There are different exercises that can be performed by the audiologist. The most commonly used treatment is called the Epley Maneuver or Canalith Repositioning Therapy. It consists of a series of different body and head positions that will get the dislodged “crystals” where they belong. Most of the cases a single treatment will be effective.
However, it’s highly recommended that this therapy is performed by a professional because any wrong or inadequate position or movement can move the dislodged “crystal to other canal and the symptoms can be more intense and treatment is also different and complicated.