Dizziness & Vertigo

BPPV (Benign Paroxysmal Positional Vertigo)

What is BPPV?

You may have heard your doctor mention this condition to you while examining you, but you’re unsure as to what it is. It is a condition that causes short lived bouts of vertigo (dizziness). 25% of cases of vertigo are as a result of BPPV. Other reasons include acoustic neuroma, Meniere’s disease and vestibular migraines. Vertigo is a symptom of BPPV and it provides an illusion of movement, without any motion occurring. BPPV regularly occurs on movement of the head, particularly turning in bed and extension (looking up) with the head.

What causes BPPV?

Within your inner ear are a number if semicircular canals filled with fluid. With movement, this fluid moves from canal to canal and this provides the brain with information of head position. Also within the ear are crystals that are usually held in a non-sensitive part of the inner ear. Through trauma and deterioration of the structures, these crystals move into a sensitive part of the inner and disrupt fluid flow.

What are the symptoms of BPPV?

Symptoms include:

• Unexpectedbouts of vertigo
• Nausea
• Difficulty focusing with your eyes
• Certain head movements provoke dizziness
• Bouts last up to 1 minute

  Phrases used by patients explaining the symptoms include: being on a bouncing castle, standing on a ship and swaying in the wind.

  

How is BPPV diagnosed?

The Physiotherapist at APW will use a number of different techniques to diagnose BPPV. These include:

Examining the Medical History – condition such as ear infections, low blood pressure and traumatic head or ear injuries can cause symptoms such as vertigo.

Physical Examination – This includes tests such as the Dix-Hallpike which moves the body into a provocative position so to confirm or refute the diagnosis of BPPV.

ENG – This is an eye test that examines for a nystagmus (irregular eye flicker).

Scans – Tests such as MRI’s can be useful to diagnose the condition.

Ear Tests – Hearing tests can be beneficial

How is BPPV treated?

The Physiotherapist at APW will apply precise movements and exercises that will gently relocate the crystals to a different area of the inner ear that is less sensitive and does not provoke dizziness. These exercises include the Brandt-Daroff technique and Semont and Epley’s Manoeuvre. It has been reported that there can be up to a 90% success rate after performing BPPV techniques.

Who can help you?

The Physiotherapists at APW can diagnose and treat BPPV successfully and can help you get back on your feet with a steady head.

Article by Paul Lennon (Physiotherapist)