What is BPPV?

BPPV is the most common form of positional vertigo and it accounts for nearly half of all the people with peripheral vestibular dysfunction. It is seven times more common in persons over the age of 60 years. 

It is called Benign Positional Paroxysmal Vertigo.

Benign: not harmful in effect or non- fatal

Paroxysmal: sudden attack 

Positional : triggered by positions mostly head movements or rolling on the bed

Vertigo: illusion of the movement of surrounding or self, perceived as spinning

Simply put, the crystals (otoconia) from the  bags (otolith) somehow find their way into the semicircular canals. This sends altered sensory inputs to the brain and in turn, the brain sends input to eye muscles which causes the eyeballs to move in different directions (Nystagmus). This causes an illusion of movement of the surroundings or self which feels like spinning. A detailed patient interview will determine if it is BPPV or not. Your description of symptoms can be extremely helpful in diagnosing this problem.

Causes:

1. Unknown/ idiopathic 

2. More likely to occur over the age of 50 years- age related wear and tear 

3. Head trauma in younger population –knocks the crystals off

4. Other theories- Vitamin D Deficiency and calcium metabolism

5. Associated with other vestibular conditions like neuritis, labyrinthitis, ear surgeries, vestibular migraines and menieres’ disease  

BPPV is position dependent. The vestibular therapist uses specific head and body positions to test which canals may be affected. Since this is a mechanical issue, MRI/CT scans are of no use. No medications can help you get these crystals back in position. Most medications will suppress the vertigo sensation. 

Vestibular therapists take specialized training in determining the type of eye movements and provide specific maneuvers to treat them. Common maneuvers are the Epley’s and Barbeque roll.

It usually takes 3-5 sessions to eliminate these crystals from the canals. The efficacy of these maneuvers can be anywhere from 80-95%.

Disclaimer: The information on this page is  for information and education only. It is not intended to replace the care provided by your qualified health professional. Please contact us if you think you could benefit from vestibular therapy. Book a 15 min free consultation to discuss your symptoms in detail and create a treatment plan.

- Priti Jadiya, Vestibular Therapist