SNS-ffvertigo081318a_B

Dr. Andrea Livingston

BPPV is one of the most common causes of vertigo. It is characterized by brief episodes of mild to intense dizziness, which may last anywhere from a few seconds to a few minutes. The dizziness may be triggered by upward/downward head movement, turning your head to one side, rolling over, laying on your back and possibly standing up or walking. Luckily, BPPV is easily identified, and most patients who receive treatment recover fully.

Causes of BPPV: About 50 percent of the time a direct cause for BPPV cannot be identified. However, it can be associated with head trauma, inner ear damage, migraines, aging of the hearing/balance system and, in rare cases, ear surgery. It is more common in elderly adults.

Role of the Inner Ear and BPPV: The balance system is made up of your inner ear, eyes and proprioception (sensory receptors in muscles, joint capsules and surrounding tissues - that signal information to the central nervous system about position and movement of body). The balance portion of the inner ear consists of three semicircular canals (which sense head position) and the utricle and saccule (which sense gravity and acceleration). The system contains small crystals called otoconia. In BPPV, the otoconia (crystals) are dislodged and move into one of the semicircular canals which are fluid filled. When the semicircular canal is stimulated by head movement, these crystals float in the fluid and cause the system to think there is movement; your eyes jerk reflexively (nystagmus) and the world appears to spin, resulting in dizziness.

Diagnosis of BPPV: A diagnosis of BPPV can normally be made based on your medical history, a hearing test and physical examination. The Dix-Hallpike maneuver is a test specific for BPPV. There are various types of Dix Hallpike positions. Your physician or audiologist will perform an appropriate position of your body and head. Based on the type of movement of your eyes, direction of the movement and how long the “dizziness” lasts, a specific canal will be identified as the etiology for your “positional dizziness.” If you experience dizziness and nystagmus (eye jerking), this is normally considered a positive exam and confirms BPPV.

Treatment of BPPV: BPPV can be a self-limiting problem, meaning it will resolve on its own over time. However, to speed up recovery, a variety of positioning maneuvers can be performed. The goal is to move the otoconia (crystals) out of the semicircular canals and return them to where they belong. The type of maneuver appropriate for treatment is going to depend on the specifics of the eye movement, time of dizziness and physical limitations of the patient. Self-treatment is not recommended as the particles may migrate to a different part of the inner ear and then become a very difficult treatment process.

If you struggle with vertigo and are interested in seeking treatment, call your local Doctor of Audiology or for more information visit us at centralflhearing.com.

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