vertigo

Benign Paroxysmal Positional Vertigo (BPPV)

What is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) is a mechanical dysfunction of the vestibular system located in the inner ear. Symptoms of BPPV most commonly include brief period of vertigo, or the sensation that the room is spinning around you. These bouts of vertigo are most often felt when changing positions (such as sitting up in bed) or with quick head movements such as looking up or turning to the side. Vertigo from BPPV is abrupt, intense, and sometimes violent and accompanied by nausea. It lasts for a few seconds, but the after-effect can be longer.

What causes BPPV?

BPPV occurs when small crystals within the ear become displaced from the uticle, where the crystals are normally located, into the semi-circular canals. Most of the time, this occurs insidiously and the cause is unknown, although head trauma can also result in BPPV.

When the crystals are displaced into the semi-circular canals, they flow through the fluid within the canals which is what causes the sensation of vertigo. When the crystals settle at the bottom of the canal, the vertigo terminates. Vestibular therapy can help shift the crystals out of the canals to help resolve your symptoms and get you back on track.

How is BPPV treated?

A trained physical therapist will determine if your symptoms are truly caused by BPPV, and if so, which of the three semi-circular canals has been impacted. During the positional tests used for diagnosis of BPPV, the therapist looks for involuntary eye movements called nystagmus. Based on the direction of the nystagmus combined with the determination of which directions cause your symptoms, the therapist can determine which canal the crystals are located.

Your therapist will then use canalith repositioning maneuvers to help shift the crystals out of the canals and back in the uticle to help relieve your symptoms. Most often, BPPV and the associated symptoms can be relieved within approximately 3 sessions.

Your therapist may also show you a similar sequence of head and body movements that you can perform at home. Some people find that incorporating repositioning movements into their daily routine help keep more persistent symptoms of vertigo at bay.

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