Vertigo, described as a sense of spinning, is a symptom of a number of conditions and can be highly distressing. One of the most common causes of vertigo is BPPV which can be easily diagnosed and treated by an experienced vestibular physiotherapist.

Image source: Houston Methodist Leading Medicine https://www.houstonmethodist.org/

BPPV - that sounds like a mouthful!

It is. Benign Paroxysmal Positional Vertigo occurs when tiny crystals, called otoconia, dislodge from their home in the utricle (see diagram) and float into one of the semicircular canals. This occurs in the vestibular system in the inner ear; its primary role is to tell the brain where the head is in space, essential for orientation and balance. Presence of the crystals in the canals distorts these messages and the resulting symptoms include vertigo, nausea and imbalance.

Picture Source: dizziness-and-balance.com

KEY POINTS:

Benign - this is a very treatable condition with no sinister cause
Paroxysmal - symptom onset is very sudden
Positional - vertigo is associated with a change in head or body position, most commonly rolling over in bed, bending down and looking up. Symptoms usually last up to a minute while the crystals are moving in the semicircular canal fluid - once they settle again (with gravity) the vertigo subsides.

So, what causes BPPV?

There are a number of causes of BPPV, including:

Degeneration associated with ageing
Head trauma (including indirect trauma such as whiplash)
Damage caused by an inner ear disorder or infection eg. vestibular neuritis
BPPV is also associated with migraine, osteoporosis and low vitamin D levels.

ON A SIDE NOTE…

In elderly people, BPPV symptoms can be much more vague and BPPV is responsible for over 50% of dizziness reported by elderly people. Sometimes they might just feel a bit lightheaded or off balance. If these symptoms come on suddenly and are worse with movement, BPPV assessment is warranted.

How is BPPV treated?

While BPPV can resolve by itself with time, treatment is much faster and highly effective. One of our physios saw a patient recently who had been living with untreated BPPV for seven years… sadly not everyone knows that specialised physios can treat vertigo.

Symptom history and physiotherapy assessment with infrared video goggles is used to make an accurate diagnosis. Moving quickly into certain positions stimulates the floating crystals and triggers characteristic eye movements that are visible to the assessing physiotherapist.

Once the affected semicircular canal is identified (there are 3 in each ear) the physio performs a repositioning maneuver to drain those pesky crystals out of the affected canal.

How will I feel after treatment?

It depends. Some people dance out of our clinic having never felt better, and others feel pretty rubbish and have what we call a “treatment hangover” for the next 24 hours or so. We encourage patients to have someone drive them to their appointment so that they are safe getting home again. Often only one treatment session is needed though sometimes, repeated treatments are necessary.

If you haven’t experienced vertigo yourself, you probably know someone who has. BPPV is 100% treatable and the team of vestibular physios at Neuro Physio Geelong are here to help.