BPPV: What Is It, How Do We Treat It, and How Can You Help?
If you’ve ever experienced sudden, intense dizziness or the sensation that the room is spinning or tumbling, you may have encountered a condition known as Benign Paroxysmal Positional Vertigo, or BPPV. While the symptoms of BPPV can be alarming, the good news is that this condition is treatable, and vestibular therapy plays a key role in helping patients find their footing and climb back to a better quality of life.
What is BPPV?
Benign Paroxysmal Positional Vertigo (BPPV) is a disorder of the inner ear that causes brief episodes of dizziness or vertigo when a person changes their head position. It’s one of the most common causes of vertigo, especially among older adults, but can affect anyone.
The inner ear is responsible for maintaining balance, and it contains tiny crystals, called otoconia, that help detect movement and orientation. In BPPV, these crystals become dislodged from their normal position in the utricle, a part of the inner ear, and migrate into one of the semicircular canals, another part of the inner ear. When the head moves, these loose crystals can shift and interfere with normal fluid movement in the canal, sending false signals to the brain about the body’s position. This leads to the characteristic spinning sensation and loss of balance that people with BPPV experience.
What Are the Symptoms of BPPV?
The hallmark symptom of BPPV is sudden, intense sensation of vertigo triggered by specific head movements, such as turning over in bed, looking up, bending over, or lying back in bed. Other symptoms can include:
Dizziness or a sense of spinning or tumbling (vertigo)
Nausea or vomiting from dizziness
Imbalance or unsteadiness, particularly when walking or standing up
Because these symptoms can be related to a variety of other conditions, it’s important to consult with a healthcare professional for a proper diagnosis and treatment plan.
How Is BPPV Diagnosed?
To diagnose BPPV, your healthcare provider will typically conduct a series of tests, including a physical exam and a specialized maneuver called the Dix-Hallpike test. This test involves having you lie down on an exam table while your head is positioned at specific angles to trigger vertigo. Your provider will also watch your eyes for particular movements, called nystagmus, as well as ask about any symptoms throughout testing, that may confirm a diagnosis.
Your healthcare team may also use other diagnostic tools, such as imaging studies, to rule out other potential causes of dizziness, such as a stroke or tumor.
How Do We Treat BPPV?
The primary treatment for BPPV is a series of maneuvers designed to move the displaced otoconia back to their proper position in the inner ear, where they can no longer cause dizziness. These maneuvers are performed by a trained healthcare professional, often a vestibular physical therapist.
The most commonly used maneuver is the Epley maneuver, which involves a sequence of head movements designed to guide the displaced crystals through the semicircular canal and back into the utricle, where they no longer cause symptoms. The Epley maneuver is highly effective, with a success rate of over 80%, and is usually performed during a single session. Other maneuvers, like the Semont maneuver or Log Roll, may also be used depending on the location of the crystals in the inner ear.
In addition to these repositioning maneuvers, vestibular rehabilitation therapy can help patients improve balance, reduce dizziness, and prevent future episodes. VRT includes exercises that help the brain adapt to changes in balance and can improve overall coordination.
Can You Help with BPPV?
While BPPV is treatable, there are things you can do to help manage the condition, particularly after receiving treatment. Here are some tips for individuals who are dealing with BPPV:
Follow Up on Vestibular Physical Therapy: If you’ve been prescribed vestibular rehabilitation therapy, be sure to follow through with the exercises as directed. These exercises help retrain your brain to process balance information more effectively.
Modify Your Movements: Avoid sudden head movements, especially in the first few days after treatment. Be cautious when rolling over in bed, bending down, or tilting your head up, as these positions can trigger symptoms.
Stay Safe: If dizziness is causing balance issues, use assistive devices like a cane or walker for added stability. Fall prevention is key in managing BPPV, especially for older adults.
Be Patient: Though BPPV episodes can feel severe, they typically resolve with the right treatment. However, recurrence is possible, and if symptoms return, don’t hesitate to seek treatment again.
When to Seek Professional Help
BPPV may cause intense and sudden dizziness, but with the right diagnosis and treatment, most people can find relief. Vestibular physical therapy plays a crucial role in helping patients with BPPV regain balance and live life without the fear of vertigo. If you or someone you know is struggling with dizziness, don’t hesitate to reach out to a vestibular specialist. With treatment, you can get back to living your life, free from the spinning sensation of BPPV.
If you think you may be suffering from BPPV, or if you have questions about how vestibular therapy can help, contact us today to schedule an appointment. Our team is here to guide you through the treatment process and help you find lasting relief.
