Understanding Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo, a sensation of spinning or dizziness. This condition arises from issues within the inner ear, specifically the semicircular canals, which are responsible for maintaining balance.

What Causes BPPV?

BPPV occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their usual location in the utricle and migrate into the semicircular canals. These crystals disrupt the normal fluid movement in the canals, sending false signals to the brain about head movements. This miscommunication results in the sensation of vertigo.

Common factors responsible for otoconia displacement:

• Head trauma or injury.

• Vitamin D Deficiency

• Age-related degeneration of the inner ear structures.

• Diabetes Mellitus/Hyperinsulinism/Hyperglycemia

• Osteoporosis

• Meniere’s Disease

• BPPV is frequent in females older than 50 years old

• Vascular Comorbidities (Hypertension, Hyperlipidemia, Cardiovascular Disease)

• Migraine

• Cervical Osteoarthritis (Spondylosis)

BPPV is triggered by sudden changes in head position, such as lying down or turning over in bed.

Symptoms of BPPV

The hallmark symptom of BPPV is brief episodes of vertigo, typically lasting less than a minute, triggered by specific head movements. Other symptoms may include:

• Dizziness or lightheadedness.

• Nausea or vomiting.

• Loss of balance or unsteadiness.

It's important to note that BPPV does not cause hearing loss or tinnitus, distinguishing it from other inner ear disorders.

Diagnosis

BPPV is diagnosed through clinical assessments, including the detailed case history and VNG testing especially positional tests. This test involves specific head and body movements to elicit vertigo and observe nystagmus (involuntary eye movements), which helps pinpoint the affected semicircular canal.

Treatment Options

The primary treatment for BPPV involves repositioning maneuvers, such as the Epley maneuver. These guided head and body movements aim to move the dislodged crystals back to their original location in the utricle. In cases where standard maneuvers are ineffective, advanced techniques or devices like the TRV Chair may be used for precise repositioning.

Living with BPPV

While BPPV is not life-threatening, its symptoms can significantly impact daily life. Simple lifestyle adjustments, such as avoiding sudden head movements and sleeping with the head slightly elevated, can help manage symptoms. Regular follow-ups with a healthcare provider are essential to monitor and address recurrences.

Conclusion

BPPV is a manageable condition with proper diagnosis and treatment. Awareness and understanding of its symptoms and triggers can empower individuals to seek timely medical care, ensuring a better quality of life.