Benign Paroxysmal Positional Vertigo
BPPV is an acronym that stands for and means: Beneficial (it is often not a serious condition), Paroxysmal (happens abruptly and briefly), Positional Vertigo (dizziness occurs by changes in head position like when you tilt your head up or down, lying flat, turning to the other side of the bed, or bending over)
How does BPPV happen?
Inner ear structure:
Each of our inner ear has 5 balance organs: 3 semicircular canals and 2 otolith organs (saccule and utricle) which contains tiny calcium carbonate crystals (otoconia) and are all connected by inner ear fluid.
Cause of BPPV
BPPV is caused by free floating crystals within the sensitive parts of inner ear. These crystals are made up of calcium carbonate. There is a structure within the inner ear called Otoconia made up of calcium carbonate crystals. The otolith organs are the organ which detect movements and transmit it to the brain, allowing us to determine which way is up, down, forward or backward. Sometimes minor injuries or sudden head movements can cause displacement of these crystals into the fluid inside the inner ear. These crystals will then float freely in the inner ear fluid and moves with the position of head. Moving your head in certain positions will cause these crystals to shift and travel inside the semicircular canal fluid to the posterior semicircular canal (The most common form, accounting for 81% to 90% of all cases).This may irritate the balance organs inside the inner ear and send out false signals to the brain causing vertigo
BPPV happens when some of the tiny crystals (otoconia) become loose and disconnected from their location, they will float freely in the inner ear fluid. When this happens moving your head in certain positions will cause these crystals to shift and travel inside the semicircular canal fluid to the posterior (The most common form, accounting for 81% to 90% of all cases). This causes the onion-shaped structure (known as the cupula), which provides our body’s sense of direction, to send incorrect signals to the brain, resulting in vertigo.
- Dizziness/lightheadedness (vertigo)
- Trouble with balance
- Difficulty concentrating
- Nausea (moderate to vomiting)
Very often, the symptoms go away and then come back weeks or months later. Without treatment, symptoms might continue for a few weeks before going away. For some people, the symptoms never come back after the first time.
Although BPPV can be bothersome, it's rarely serious. However, if it raises your risk of falling, please see your doctor.
BPPV rarely affecting both ears and/or more than one canal at the same time. Episodes are brief (lasting seconds)
What causes the tiny crystals (otoconia) become loose and disconnected from their location?
There are a few reasons why crystals may become loose inside your inner ear and cause BPPV, including: Mild to moderate head injury (including whiplash) , Vestibular Neuritis (an inner ear infection), Meniere’s Disease (combination of vertigo, tinnitus (ringing in the ears) and hearing loss)
How do doctors treat BPPV?
Doctors usually treat BPPV by doing the Epley maneuver. This maneuver is a special way of moving your head and body. It shifts the loose particles to a different part of your ear so they don't cause problems.
To do the Epley maneuver do the following and hold each position for about 30 seconds:
- Sit down on a table or bed and turn your head halfway to the right
- Lie down on your back with your head still turned to the right and let your head hang off the end of the table or bed
- Turn your head to the left, then turn your head and body all the way to the left so your nose points to the floor
- Slowly sit up, but keep your head turned all the way to the left
- Once you’re sitting up, turn your head to face forward