Benign Paroxysmal Positional Vertigo Essentials – An Overview of Signs, Symptoms and Treatment Options

Patients with vertigo mistakenly experience movement (commonly a spinning motion) in their surroundings. Vertigo can hinder balance, causing falls which can be serious among older adults, and may be accompanied by dizziness, a feeling that you’re spinning or falling, and in serious cases migraine headaches, nausea, vomiting, an inability to see properly (nystagmus), as well as fainting spells.

There are many root causes for vertigo, but one form of it – benign paroxysmal positional vertigo, or BPPV – relates to your sense of hearing. It occurs as the result of calcium crystals that form naturally known as otoconia or otoliths, which in most people cause no issues. In people who are afflicted with BPPV, however, these crystals become dislodged from their normal location and travel into one of the semicircular canals that control our sense of balance. Once they are within the semicircular canals, the crystals trigger an abnormal displacement of endolymph fluid every time a person alters the position of their head (relative to gravity). This is the root cause of the vertigo feelings in cases of benign paroxysmal positional vertigo.

Everyday actions such as looking up and down, tilting your head or rolling over in bed can trigger the BPPV. The vertigo sensation comes on very suddenly and has a short duration. Changes in barometric pressure, sleep disorders and stress can make the symptoms worse. The disorder can manifest itself at any age, however it typically appears in individuals over age 60. It’s tricky to pinpoint the specific cause of benign paroxysmal positional vertigo for any given patient, but it commonly develops following accidents in which the person receives a blow to the head.

BPPV is differentiated from other types of vertigo or dizziness in that it is nearly always brought on by head movements, and in that its effects usually decrease in less than a minute. Doctors may diagnose it by having the affected individual rest on their back and then tip their head to one side or over the edge of the examination table. Other tests which can be used to diagnose BPPV include electronystagmography (ENG) or videonystagmography (VNG), which test for abnormal eye movement, and magnetic resonance imaging (MRI), whose primary role is to rule out other potential causes, such as brain tumors or brain abnormalities.

There’s no complete cure for BPPV, but it can be successfully treated using canalith repositioning (either the Epley maneuver or the Semont maneuver), both of which use physical movements to shift the crystals to an area in which they no longer cause problems.Surgical treatment is an option in the exceptional cases where these treatments are not effective. See your doctor if you have felt symptoms which seem as if they could be associated with BPPV, especially if they last for more than a week.

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