Description

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in head position. This can occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it is rarely fatal, except when it increases the likelihood of falls. You can receive effective treatment for BPPV during a visit to the doctor's office.

Symptoms

The signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include:

  • Dizziness
  • A feeling that you or your surroundings are spinning or moving (vertigo)
  • A loss of balance or unsteadiness
  • Nausea
  • Vomiting

The signs and symptoms of BPPV can go and come, and typically last less than a minute. Episodes of BPPV may disappear for a time and then repeat.

Activities that bring about the signs and symptoms of BPPV can vary from person to person, but are almost always brought about by a change in the position of the head. Some people also feel out of balance when standing or walking.

Abnormal rhythmic eye movements usually accompany the symptoms of benign paroxysmal positional vertigo.

When to see a doctor

In general, check with your doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained dizziness or vertigo.

Seek emergency medical attention

Although it is rare for the dizziness to the signal of a serious illness, consult your doctor immediately if you experience dizziness or vertigo along with any of the following:

  • A new, different, or severe headache
  • A fever
  • Double vision or loss of vision
  • Hearing loss
  • Difficulty speaking
  • The leg or arm weakness
  • Loss of consciousness
  • Falling or difficulty walking
  • Numbness or tingly feeling

The signs and symptoms described above may be a sign of a more serious problem.

Causes

Often, there is no known cause for BPPV . This is called idiopathic BPPV .

When there is a known cause, BPPV is often associated with a minor-to-severe blow to the head. Less common causes of BPPV include conditions that damage the inner ear or, in rare cases, the damage that occurs during ear surgery or long periods of time located in the rear, as in a dental chair. BPPV has also been associated with migraine.

The ear of the paper

Inside your ear is a tiny organ called the vestibular labyrinth. Includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hairlike sensors that monitor the head of the rotation.

Other structures (organs otoliths) in the ear of the monitor of your head movements up and down, left and right, back and forth, and the head of the relative position of the gravity. These otolith organs contain crystals make you sensitive to gravity.

For many reasons, these crystals can become dislodged. When you tear off, you can move into one of the semicircular canals — especially while lying down. This causes the semicircular canal to be sensitive to the changes of position of the head usually does not respond, that is what makes you feel dizzy.

Risk factors

Benign paroxysmal positional vertigo is more frequent in people over 50 years of age, but can occur at any age. BPPV is also more common in women than in men. A head injury or any other disorder of the balance organs of the ear may make you more susceptible to BPPV .

Complications

Although BPPV is uncomfortable, it rarely causes complications. The dizziness BPPV can make it unstable, which can put you at greater risk of falls.

Diagnosis

Your doctor may do a series of tests to determine the cause of your dizziness. During a physical exam, your doctor will likely look for:

  • The signs and symptoms of dizziness that are prompted by eye or head movements and then decrease in less than a minute
  • Dizziness with specific eye movements that occur when you lie on your back with your head turned to one side and tipped slightly over the edge of the examination bed
  • Involuntary movements of the eyes from side to side
  • Inability to control the movements of the eye

If your doctor cannot find the cause of your signs and symptoms, he or she may order additional tests, such as:

  • Electronystagmography (ENG) or videonystagmography (VNG). The purpose of these tests is to detect abnormal eye movement. SPA (which uses electrodes) or VNG (that uses small cameras) can help you to determine if the dizziness is due to inner ear disease by measuring involuntary movements of the eyes, while his head is placed in different positions or their balance organs are stimulated with the water or the air.
  • Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of the head and the body. Your doctor can use these images to identify and diagnose a wide range of conditions. Magnetic resonance imaging can be performed to rule out other possible causes of vertigo.

Treatment

Benign paroxysmal positional vertigo can disappear within a few weeks or months. But, to help relieve the BPPV afternoon, your doctor, audiologist or a physical therapist can treat with a series of movements known as the canalith repositioning procedure.

Canalith repositioning

Is performed in your doctor's office, the canalith repositioning procedure consists of several simple and slow maneuvers for the positioning of your head. The goal is to move the particles of the fluid-filled semicircular canals of the inner ear inside a small baglike open area (portal) which houses one of the organs otoliths in your ear, where these particles do not cause problems and are more easily absorbed.

Each position is held for approximately 30 seconds after any symptoms or abnormal eye movements stop. This procedure usually works after one or two treatments.

Your doctor will probably teach you how to perform the procedure itself, so that you can do at home if necessary.

Alternative surgical

In rare situations, when the canalith repositioning procedure does not work, your doctor may recommend a surgical procedure. In this procedure, a bone plug is used to block the part of the inner ear that causes dizziness. The stopper prevents the semicircular canal in the ear to be able to respond to the movements of the particles or of the movements of the head in general. The success rate for the channel to connect the surgery is approximately 90%.

Lifestyle and home remedies

If you experience dizziness associated with BPPV , keep these tips in mind:

  • Be aware of the possibility of losing your balance, which can lead to falls and serious injuries.
  • Avoid movements, such as search, that in the symptoms.
  • Sit down immediately when you feel dizzy.
  • Use a good light, if you get up in the night.
  • Walking with a cane for stability, if you are at risk of falling.
  • Work closely with your doctor to manage your symptoms effectively.

BPPV can reoccur even after successful therapy. Although there is no cure, the condition can be managed with physical therapy and treatments in the home.

Preparing for your appointment

Make an appointment with your doctor if you have common symptoms of BPPV . After an initial examination, your doctor may refer you to an ear, nose and throat (ENT) specialist or a doctor who specializes in the brain and the nervous system (neurologist).

Here's some information to help you prepare for your appointment.

What you can do

  • Write down your symptoms, including when they started and how often they occur.
  • Note any of the latest blows to the head, even minor accidents or injuries.
  • Make a list of your key medical information, including any other condition you are being treated, and the names of the medicines, vitamins, and supplements you are taking.
  • Write down questions to ask your doctor. The creation of your list of questions can help you make the most of your time with your doctor.

Questions to ask the doctor at the first appointment are:

  • What are the possible causes of the symptoms or condition?
  • What tests do you recommend?
  • If these tests do not realize the cause of my symptoms, what additional tests might I need?
  • I need to follow any restrictions, while waiting for a diagnosis?
  • You should see a specialist?

Questions if you are referred to a specialist include:

  • What treatments are most likely to help me feel better?
  • How soon after the start of treatment should say to my symptoms start to improve?
  • If the first treatment does not work, what would you recommend then?
  • Am I a candidate for surgery? Why or why not?
  • What self-care measures can help me manage this condition?
  • Do I need to limit my activities? For how long?
  • Am I at risk of this recurring problem?
  • I have these other health conditions. How can I manage these conditions?
  • What the brochures or websites I recommend to learn more about BPPV ?

What to expect from your doctor

The doctor who attends to the common symptoms of BPPV can ask a series of questions, such as:

  • What are your symptoms, and when did you first notice them?
  • Do your symptoms come and go? What's the frequency?
  • How long do your symptoms last?
  • Is there anything in particular seem to trigger your symptoms, such as certain types of movement or activity?
  • Do your symptoms include vision problems?
  • Do your symptoms include nausea or vomiting?
  • Do your symptoms include headache?
  • Has lost any hearing?
  • Are you being treated for any other medical condition?
Symptoms and treatment of Benign paroxysmal positional vertigo (BPPV)