What is
Benign Paroxysmal Positional Vertigo?
Benign
Paroxysmal Positional Vertigo (BPPV) is
one of the most common forms of
vertigo. The name is a descriptive
diagnosis. “Benign” means that the
disease is self-limited and that it
might go away on its own. “Paroxysmal”
means that the symptoms come on in
bursts or spasms. “Positional” means
that certain positions cause the
symptoms. “Vertigo” is a very specific
form of dizziness; it is the sensation
of spinning.
Signs and
Symptoms:
The
typical symptoms of BPPV are a sensation
of spinning when putting the head into a
certain position. Often vertigo occurs
when the patient lies down in bed and
turns to one side. It may also occur
when reaching for an object above head
level, thus it’s other name “top-shelf
vertigo.” This movement can produce a
severe, but brief (usually less than one
minute) spinning sensation. Sometimes
the vertigo produces nausea. Many times
the sensation is severe and patients
learn to avoid getting into positions
that cause the vertigo. Your physician
can tell if you are having this
condition by watching your eye movements
when placing your head and body into
certain positions.
Causes:
Benign
Paroxysmal Positional Vertigo (BPPV) is
a mechanical problem in the inner ear
that is caused by calcium
particles or crystals in one of the
loops of the canals that sense head
motion. Calcium carbonate crystals are
found normally in a part of the inner
called the saccule and the utricle.
Occasionally, the crystals break off in
a large number and float in the fluid of
the inner ear. This dumping of crystals
can occur as a result of head trauma,
viral illness, surgery or the aging
process. The crystals drop down into
the posterior canal and produce
stimulation of this canal with certain
head positions. This movement in the
canal is perceived by the brain as
head-turning and it produces the
sensation of vertigo and involuntary
movement of the eyes called “nystagmus.”
Treatment:
Canalith
repositioning is an effective form a
treatment for this disorder. In this
painless, bloodless procedure performed
in the doctor's office, the patient is
moved in certain ways to put the
crystals back into a part of the inner
ear where they will not cause episodes
of vertigo. This procedure lasts about
10 minutes. You will be seen two weeks
after the procedure to assess its
success or failure. If the first
procedure has not solved the problem, a
second one will be performed. Usually 9
out of 10 patients will experience
relief of their symptoms with this type
of therapy.
Success of
Treatment:
The treatment
results in a high success rate; however,
more than one treatment session may be
required. Overall, about nine out of
ten patients have no more vertigo
following this treatment. Rare side
effects of treatment include:
-
Post-treatment
vertigo.
-
Minor neck pain
associated with the treatment
Canalith
Repositioning Instructions.
It is very
important not to eat before this
procedure since the vertigo can cause
nausea. If you must eat beforehand, eat
lightly.
Dress in
comfortable clothing.
If you do this
in the office or in the physical
therapist's office, it is recommended
that you bring someone with you in case
you are unable to drive, since the
procedure may make you feel dizzy and/or
nauseated.
Post
Procedure Instructions:
-
Sleep
in a recliner or sleep with
several pillows under you so
that you are at an angle
of 45 degrees for the first 48
hours.
-
Avoid
sleeping on the affected side
for the first week after the
treatment.
-
Refrain
from picking up objects from the
floor or bending over for the
first week following the
treatment.
-
Schedule an appointment to see
your physician two weeks
following the treatment.
