Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a type of dizziness that is characterized by brief, intense episodes of vertigo (a spinning or whirling sensation) that are triggered by specific head movements. It is caused by the displacement of small calcium carbonate crystals (otoconia) from their normal location in the inner ear to one of the semicircular canals. This results in the stimulation of the hair cells in the affected canal, leading to a false sense of movement. BPPV is considered benign as it is not life-threatening and typically resolves on its own within a few weeks or months. However, in some cases, it may persist or recur, and treatment may be required to relieve symptoms. Common treatments for BPPV include canalith repositioning procedures, such as the Epley maneuver, and exercises to improve vestibular (balance) function.

Causes of Benign Paroxysmal Positional Vertigo

The exact cause of benign paroxysmal positional vertigo (BPPV) is not fully understood, but it is thought to be related to changes in the inner ear that result in the displacement of small calcium carbonate crystals (otoconia) from their normal location in the utricle to one of the semicircular canals. Some common causes of BPPV include:

Age-related changes: As people age, the otoconia in their inner ear may become more brittle and prone to breaking loose and migrating to the semicircular canals.

Head injury: A traumatic head injury can cause the otoconia to become dislodged and migrate to the semicircular canals, leading to BPPV.

Infections: Certain ear infections, such as labyrinthitis, can result in inflammation and swelling of the inner ear, leading to the displacement of otoconia.

Chronic medical conditions: Certain medical conditions, such as Meniere’s disease and migraines, can cause changes in the inner ear that result in BPPV.

Certain medications: Some medications, such as diuretics, can cause changes in the inner ear that result in the displacement of otoconia and the development of BPPV.

It is important to note that in some cases, the cause of BPPV may be unknown.

Signs and Symptoms of Benign Paroxysmal Positional Vertigo

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

• Vertigo: A spinning or whirling sensation that is triggered by specific head movements, such as lying down, sitting up, turning over in bed, or bending over.
• Nausea: A feeling of sickness or discomfort in the stomach, often accompanied by a desire to vomit.
• Balance problems: Difficulty maintaining balance or a tendency to fall, especially when walking or standing.
• Nystagmus: Involuntary eye movements that occur as a result of the stimulation of the hair cells in the affected semicircular canal. Nystagmus can result in a sensation of dizziness or unsteadiness.
• Headaches: Mild to moderate headaches that may occur in association with episodes of vertigo.
• Tinnitus: Ringing in the ears, which may be present in some cases of BPPV.

It is important to note that the symptoms of BPPV can vary from person to person and may be influenced by several factors, such as the severity of the condition, the frequency of episodes, and individual differences in the structure and function of the inner ear.

Treatment for Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a type of dizziness that occurs as a result of a problem in the inner ear. Physiotherapy can be an effective treatment option for BPPV.

A typical physiotherapy program for BPPV may include:

Vestibular rehabilitation exercises: These exercises can help to improve the function of the inner ear and reduce the symptoms of BPPV.

Canalith repositioning procedures: This is a specific maneuver performed by a physiotherapist to help move the small crystals in the inner ear back to their proper location.

Gaze stabilization exercises: These exercises help to improve visual stability and reduce dizziness during head movement.

Balance training: This may include exercises to improve standing balance and walking, as well as more advanced balance activities that challenge the vestibular system.

Education and advice: Physiotherapists can provide information on what causes BPPV and tips for reducing dizziness in everyday activities.

It’s important to note that the specific physiotherapy treatment for benign paroxysmal positional vertigo (BPPV) will vary based on the individual and the severity of their symptoms. A physiotherapist can develop a personalized treatment plan based on a thorough assessment of the individual’s specific needs and symptoms.

If you have any questions or would like to speak to a therapist about benign paroxysmal positional vertigo please call us at 03 9836 1126.

Reference:

Lin, H., Liu, Y., & Lin, J. (2018). The effectiveness of vestibular rehabilitation therapy in patients with benign paroxysmal positional vertigo: A randomized controlled trial. Journal of Physical Therapy Science