A GUIDE TO BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)
Benign paroxysmal positional vertigo (BPPV) is a prevalent inner ear disorder characterized by short, intense episodes of vertigo or dizziness triggered by changes in the head’s position. This condition occurs due to the displacement of calcium carbonate crystals, known as otoconia, within the semi-circular canals of the inner ear. The movement of these crystals disrupts the normal fluid flow within the canals, sending incorrect signals to the brain about the body’s position and causing the sensation of spinning.
CAUSES OF BPPV
BPPV is primarily caused by the dislocation of otoconia from their usual position in the utricle, leading to their accumulation in one of the semi-circular canals. This displacement can result from:
Minor Head Injuries
Even a slight bump or knock to the head can dislodge these crystals.
Degeneration of the Vestibular System
Natural aging processes can contribute to the detachment of otoconia.
Other Factors
Conditions like inner ear infection or prolonged positioning on the back (such as during dental procedures or hair salon visits) can also trigger BPPV.
TYPES OF BPPV AND INDIVIDUAL TREATMENTS
BPPV is classified based on the affected canal and the location of the crystals within it. The two primary types are:
CANALITHIASIS
In this most common type, the crystals freely move in the fluid of the canal, causing brief vertigo when the head’s position changes.
The Epley manoeuvre is the primary treatment, effectively relocating the dislodged crystals to the utricle, where they no longer cause symptoms.
CUPULOLITHIASIS
Here, crystals adhere to the cupula of a semi-circular canal, making it sensitive to gravity changes.
The Semont manoeuvre or Liberatory manoeuvre can dislodge the crystals from the cupula, providing relief from vertigo.
MANAGING BPPV
BPPV symptoms can be distressing, but the condition is manageable with the right approach. Diagnosis involves specific positional tests like the Dix-Hallpike test, performed by a healthcare professional to confirm BPPV and its type.
TYPES OF BPPV AND THEIR TREATMENTS
BPPV is classified based on the affected semi-circular canal and whether the crystals are free-floating or attached to a specific part of the canal.
POSTERIOR CANAL BPPV
This is the most common form, where crystals accumulate in the posterior semi-circular canal. The Epley manoeuvre is the preferred treatment, designed to guide the crystals out of the canal and back into the utricle, where they can no longer cause vertigo. This manoeuvre involves a series of specific head and body movements performed by a trained healthcare provider and can also be taught to patients to perform at home.
HORIZONTAL (LATERAL) CANAL BPPV
In this type, crystals affect the horizontal canal. The Lempert Roll manoeuvre (or barbecue rotation) is often used, involving rotating the patient’s body along with their head around a horizontal axis to move the crystals out of the horizontal canal.
ANTERIOR CANAL BPPV
This rare form affects the anterior canal and is more challenging to treat due to the canal’s position. A modified version of the Epley manoeuvre, targeting the anterior canal, may be attempted, though its effectiveness varies.
SYMPTOMS AND DIAGNOSIS
BPPV symptoms include vertigo, nausea, and, less commonly, vomiting, triggered by specific head movements. Diagnosis typically involves the Dix-Hallpike test for posterior canal BPPV or the supine roll test for horizontal canal BPPV, aiming to elicit vertigo and observe the induced nystagmus.
PROGNOSIS AND MANAGEMENT
While BPPV can recur, it’s not considered a serious condition and often resolves within one to two weeks with proper treatment. Lifestyle modifications and precautions can help manage and reduce the risk of recurrence. These include avoiding sudden head movements that have previously triggered episodes and, in some cases, using prophylactic manoeuvres periodically.
CONCLUSION
BPPV is a manageable condition that affects a significant portion of the population, especially among older adults. Understanding the different types of BPPV and their specific treatments allows for targeted management, offering relief from the distressing symptoms of vertigo. If you experience symptoms of BPPV, seeking prompt medical advice is crucial for accurate diagnosis and appropriate treatment. With the right care, most individuals can lead a normal, vertigo-free life.
REGAIN YOUR BALANCE: TAKE THE FIRST STEP AGAINST BPPV TODAY!
If you’re experiencing sudden, brief episodes of dizziness or spinning with head movements, don’t let BPPV take over your life. Understanding the causes and types of BPPV is the first step toward effective management. Consult a healthcare professional who can offer a precise diagnosis and tailored treatment plan, including manoeuvres like the Epley or Semont, which you might also learn to perform at home safely.
Remember, while BPPV can recur, it’s highly treatable. Most individuals find significant relief or complete resolution of symptoms with proper treatment. Don’t ignore your symptoms; take action today to reclaim your balance and well-being. Make an appointment with Dr Sandeep through our appointment booking service or contact us via WhatsApp.