BPPV…a positional form of vertigo explained

BPPV…a positional form of vertigo explained

Benign Positional Paroxysmal Vertigo is the most common type of vertigo. Although the name might sound like a freakish STD, it is not contagious and the treatment of choice is actually physical therapy!

This type of vertigo is characterized by the feeling like the room is spinning around you, as if you may fall. However, unlike most dizzy spells and other types of vertigo, the precipitating factor is a change in head position….for instance sitting up from laying in bed or turning quickly from left to right. Dizziness on standing from a seated position is generally not BPPV, as this does not involve a change in the position of the head, just its position higher relative to the ground. It is, therefore, the turning in space that is the issue.

The reason why the turning of the head is the issue is because of the presence of crystal structures in the inner ear canals. These crystals in our semi-circular canals, when working correctly, help a healthy person sense where their head is positioned in space. Therefore, if you tilt your head back or left or right, you still innately know where the horizon is.

A person with BPPV, on the other hand, has defective positioning of these crystals, so the head no longer knows where it is. The result, severe dizziness and loss of balance.
so how do these crystals become altered? The most common is from a fall. This dislodges the crystals and allows them to fall into the wrong positions in the canals.
Other factors can be ear surgeries, degeneration with very advanced age or certain types of viruses.

Generally, the solution is fairly simple, and surprisingly enough falls into the physical therapy umbrella. Vestibular therapy is one of the branches of therapy all physical therapists learn in school. Not many specialize in this small, niche area, but one does not have to specialize in vestibular therapy to carry out the Epley Maneuver, the 10 minute start to finish procedure that generally rids a patient of BPPV by repositioning the crystals back to normal.

The Epley can be done easily and effectively, although generally causes symptom reproduction which can be difficult for patients to tolerate.

Once finished, it is also generally recommended to wear a neck brace and sleep semi-reclined ensure a better result. This position held ensure the crystals do not migrate back in the incorrect positions.

If you find your vertigo is brought on by your head position, you may have BPPV. If so, a simple procedure may give you lasting relief at your physical therapists office of all places!