If you’re experiencing dizziness, a condition called benign paroxysmal positional vertigo (BPPV) may be the culprit. BPPV is one of the leading causes of dizziness and can be triggered by minor head movements in many patients with the condition.
BPPV is responsible for about half of the cases of dizziness amongst older adults and 20 percent of all dizziness problems.
BPPV occurs when miniscule calcium deposits (canaliths) located on the otolithic membrane in the vestibular system are dislodged. These tiny particles then settle in the fluid contained in the semicircular canals of the inner ear. Anytime the head moves and the deposits shift, it causes vertigo.
Causes and Symptoms of BPPV
In many cases, it can be difficult to identify the cause of BPPV. It can be due to inner ear infections, prolonged bed rest, migraines, head injuries and the natural aging process. While the most common symptom of BPPV is vertigo, it can also cause lightheadedness, blurred vision, nausea and problems with concentration.
Diagnosing and Treating BPPV
Patients experiencing vertigo typically begin the diagnostic process with a physical exam. To test for BPPV, your balance specialist will observe your eye movements in response to head movements. If this is inconclusive, you may undergo VNG testing as well.
Once you receive a definitive diagnosis, treatment will begin. Treating BPPV in patients is generally done with Vestibular Rehabilitation Therapy (VRT). The goal of VRT is to desensitize your balance system to problematic movements and retrain your brain to sync signals from your vestibular system and vision. Every patient’s VRT for BPPV is different. Most VRT plans include treatments called repositioning maneuvers, which use head movement to remove the canaliths from your inner ear canal fluid. These can often provide complete relief for patients in a few quick and easy treatments.
If repositioning maneuvers are ineffective in treating your BPPV, the other options are medication or surgery. In some cases, the antibiotic gentamicin is effective in treating the condition. If not, surgery on the posterior semicircular canal occlusion or the vestibular nerve section may be the only option for relieving your vertigo.