What is Benign Paroxysmal Positional Vertigo (BPPV) | ENT Specialist

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is an inner ear disorder that causes the most common cause of vertigo, very specific dizziness, in which you feel the room spinning around you. Each part of the name describes an important part of the situation:

  • Benign means that it is not very serious. Your life is not in danger.
  • Paroxysmal means that you suddenly touch yourself, stay for a while and come and go.
  • Position means that you induce vertigo with certain postures or movements of the head.
  • BPPV is common and can usually be treated in a doctor’s office.

In rare cases, the problem can be serious if it is more likely to fall. If you take these attacks frequently, they may indicate other medical conditions. But they are often difficult to diagnose. If you have BPPV, you may have mild or severe dizziness. Changing the position of your head triggers the episode. Other actions that trigger a BPPV episode:

  • Turning the head up or down
  • Lying down
  • Turning
  • lifting up

BPPV can be uncomfortable, but dizziness is rarely serious, except when someone falls.

What happens at BPPV?

In most people, especially the elderly, there is no specific appearance of BPPV, but there are some factors that can provoke an attack:

  • Mild to severe head injury
  • Extended headrest in the dentist chair, salon, or sturdy bed rest
  • Riding a bike on rough trails
  • High-intensity aerobics
  • Another inner ear disease (ischemic, inflammatory, infectious)

Symptoms of BPPV

You can bend or change the position of your head at any time. You can lose your balance and fall. You may fear that something has gone wrong. Symptoms of BPPV include:

  • Vertigo
  • Vomiting
  • Blurry vision
  • Nausea
  • Dizziness
  • Mild headache
  • Loss of balance
  • Instability

The most common symptoms can include:

  • The feeling of the room spinning
  • Nausea
  • Vomiting
  • Instability
  • Mild headache

When to call your doctor. If you have dizziness for more than a week, you should make an appointment with your doctor. You will be able to detect an ear infection before your visit. Here’s how to do it:

  • Sit on your bed so that your head hangs over the edge when you lie down
  • Turn your head to the right and lie down quickly
  • Wait 1 minute. If you feel dizzy, the right side is affected
  • If you don’t feel dizzy, sit down, wait a moment, and repeat the test on your left side
  • If you feel dizzy when you repeat the test, your left side will be affected

Call your doctor right away if you feel dizzy or:

  • New or severe headaches can occur
  • You have a fever
  • Are you looking double or not?
  • Difficult to speak
  • You are falling or you cannot walk

Symptoms of BPPV can come and go. They usually last less than a minute.

Causes of BPPV

BPPV is the result of altering the inside of your inner ear. The semicircular canals or tubes in the ears contain fluid that moves when the body position changes. Semicircular drains are very delicate. BPPV develops when small crystals of calcium carbonate, which are normally found in another area of ​​the ear, break open and enter the semicircular canals. This also happens when these crystals form within semicircular canals. This is when your brain receives confusing messages about the position of your body.

Sometimes the crystals break off from the normal area of ​​your ear and go to other areas, including your ear canals. Once there, they can play together. Since clay is heavy compared to other objects in your ear, it will sink to the lowest part of your inner ear. When you change or change position, it causes the fluid in the inner ear to rotate after it stops moving. Create the impression that you are still moving. There are several ways to trigger BPPV by moving your head in a certain way:

  • Rolling in bed
  • Get in and out of bed
  • Yoga leans for posture
  • Tilt your head back in the salon to wash your hair
  • Rapid head movements

In general, you can expect to have rhythmic eye movements when it comes to BPPV. Your doctor will call it “nystagmus” and they will look for you if they think you have vertigo.

Risk factors of BPPV

BPPV occurs suddenly, for no apparent reason. You will most likely get it if you grow up. Parts of the inner ear begin to show wear. It is more available to women than men. In people younger than 50 years old, head injury is the most common cause of BPPV. It can be as small as a sneeze or blow to the head or as serious as a concussion or a vehicle crash.

Other reasons:

For example, having the head in the same position, at the dentist’s office or the hairdresser.

  • High-intensity aerobics
  • Riding a bike on rough trails
  • Inner ear disorder such as Meniere’s disease
  • Prolonged stay in the hospital or on bed rest
  • A specific type of migraine.

Diagnosis of BPPV

Your doctor can diagnose BPPV by performing a maneuver called the Dix-Hallpike test. Your doctor will position your head in a certain position while asking you to quickly lie on your back on the table. During this test, they will look for unusual eye movements and may ask if you are experiencing a spinning sensation. Your doctor will also do a routine physical exam. They obtain a complete medical history and undergo a neurological exam to rule out other disorders or diseases.

Additional tests may include:

  • Caloric stimulus, which heats and cools the inner ear with water or air to observe eye movements
  • Magnetic resonance of the head
  • Magnetic resonance angiography (MRA) of the head, similar to MRI
  • Computed tomography (CT scan)of the head
  • Hearing evaluation

Electronystagmography (ENG) or videonystagmography (VNG). The purpose of these tests is to detect abnormal eye movements. ENG (using electrodes) or VNG (using small chambers) can help determine if dizziness is caused by inner ear disease by measuring involuntary eye movements when the head is placed in different positions or when the extremities are stimulated. balanced with water or air.

Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor can use these images to diagnose and diagnose many conditions. An MRI may be done to rule out other causes of vertigo.

Treatment for BPPV

This condition is episodic and often goes away on its own. Your doctor can stop your BPPV with in-office treatment that will move loose crystals in your ear to a less problem area. To do this, many people can use these methods:

  • Apple maneuver: A physical therapist or audiologist can do the trick too, or you can do it yourself at home.
  • Semont maneuver: This is the USA less common than Apple in. Each one takes about 15 minutes.
  • Establishment of channel repositioning: You hold all four positions for about 30 seconds or until the symptoms disappear.

You should rest in the office for 10 minutes before going home to ensure that you do not have rapid bouts of vertigo as the crystals regenerate. You need someone to drive you. Wear comfortable clothing so that you can move easily.

Surgery: It happens less and less often, but very rarely, you may need surgery to cure your BPPV. Your surgeon will plug a part of your inner ear to prevent small calcium crystals from moving in your ear canal. Surgery has a small chance of complications, including hearing loss.

Drugs: Your doctor may prescribe medication to eliminate the spinning sensations. These may include:

  • Palliative hypnotics or sleep aids
  • Anticholinergics, which work by blocking the neurotransmitter acetylcholine.
  • Antihistamines

However, medications are often ineffective in treating vertigo.

Cure with home remedies: There are steps you can take to manage the dizziness associated with BPPV. Be aware of your surroundings and avoid putting yourself in danger. Losing your balance is always an opportunity. The waterfall can cause serious injury.

Take a seat when you feel dizzy. Sitting during a dizzy spell can help prevent you from falling. You need to be careful to have good lighting around your house and use a cane for stability.

If you experience dizziness associated with BPPV, consider these tips:

  • Be aware of the possibility of losing your balance, which can lead to falls and serious injury
  • Avoid movements that bring symptoms
  • Sit up immediately when you feel dizzy
  • Use good lighting if you get up at night
  • Walk on a cane for stability if you are at risk of falling
  • Work with your doctor to effectively manage your symptoms

BPPV can come back even after successful treatment. Although there is no cure, the condition can be controlled with physical therapy and home remedies.


Overview of the Nasopharynx In Children | ENT Specialist

What is nasopharynx in children?

Nasopharynx in children, nasopharyngeal cancer is the formation of malignant (cancer) cells in the tissues of the nasal cavity and throat. Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the nasopharynx. The nasopharynx is made up of the nasal cavity (inside the nose) and the upper part of the throat.

The nasopharynx is more common in adolescents than in children under 10 years of age. Epstein-Barr virus infection increases the risk of the nasopharynx. Any risk factor that increases the chance of getting a disease is called. Having a risk factor does not mean you have cancer; The lack of risk factors does not mean that you will not have cancer. Talk to your pediatrician if you think your baby is at risk.

Symptoms of the nasopharynx

Nasopharynx signs and symptoms; headache and a stuffy or runny nose. These and other signs and symptoms can be caused by nasopharynx or other conditions. Check with your pediatrician if your child has any of the following:

  • Headache
  • The nose is stuffy or swollen
  • Nosebleeds
  • Deafness
  • Ear infection
  • Hearing loss
  • Problems moving the jaw
  • Trouble speaking
  • Looking at the eyelid or looking at the drooping
  • Lumps in the neck can be painful

Diagnosis of nasopharynx

Tests that examine the nasopharynx can help diagnose nasopharyngeal cancer. The following tests and procedures can be used:

  • Physical exam and health history: An exam of the body to detect general signs of health, including the appearance of lumps or any abnormalities. The health habits of the patient and the history of previous diseases and treatments are also taken into account.
  • MRI (magnetic resonance imaging): The process of using magnets, radio waves, and a computer to create a series of detailed images of parts of the body such as the head and neck. This procedure is also known as nuclear magnetic resonance (NMR).
  • Nasal endoscopy: A procedure that examines organs and tissues inside the body to examine abnormal areas. A flexible or fixed endoscope is inserted through the nose. The endoscope is a thin tube-shaped device that is lightweight with a lens for viewing. It may have a tool to remove tissue samples, which a pathologist examines under a microscope for signs of disease.
  • Epstein-Barr virus (EBV) testing: A blood test to detect antibodies to the Epstein-Barr virus and Epstein-Barr virus DNA markers. They are found in the blood of EBV patients.

Stages of nasopharynx

After the nasopharynx is diagnosed, tests are done to see if cancer cells have spread to the nasal cavity and throat or other parts of the body. To plan treatment, it is important to know if cancer cells have spread to the nasal cavity or other parts of the body. The process used to find out if cancer has spread is called staging. Most children with nasopharynx are in an advanced stage at the time of diagnosis. nasopharynx most often spreads to the bones, lungs, and liver.

The following tests and procedures can be used to find out if cancer has spread:

  • Neurological exam: A series of questions and tests to check the function of the brain, spinal cord, and nerves. The test examines a person’s mood, coordination, and ability to walk normally and how well muscles, senses, and reflexes work. This is also known as a neurological test or neurological test.
  • Chest X-ray: An X-ray of the organs and bones inside the chest. X-rays are a type of energy beam that can pass through the body and into the film, creating an image of areas inside the body.
  • PET-CT scan: The process of combining images from a PET scan and a CT scan. PET and CT scans are performed simultaneously on the same machine. Combine images from both scans to create a more detailed image than the actual test produces.
  • Computed tomography (CT) scan: The process of creating a series of detailed images taken from different angles, such as the chest or abdomen within the body. The pictures are created by a computer linked to an x-ray machine. A dye may be injected into a vein or to help organs or tissues become more visible. This procedure is also known as a CT scan.
  • Bone scan: A procedure to check for the presence of rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected intravenously and travels through the bloodstream. The radioactive material collects in cancerous bone and is detected by a scanner. The drawing shows a child sliding under a scanner, a technician operating the scanner, and a computer monitor displaying images taken during the scan. A small amount of radioactive material is injected into a child’s vein and travels through the blood. Radioactive material accumulates in the bones. When the child lies on a slippery table under the scanner, the radioactive material is detected and images are created on the computer screen.

There are three ways that cancer can spread throughout the body.

Cancer spreads through tissues, the lymphatic system, and the blood:

  • Tissue: Cancer spreads from where it started growing to nearby areas.
  • Lymphatic system: It spreads from the cancer site to the lymphatic system. Cancer travels through lymphatic vessels to other parts of the body.
  • Blood: Cancer spreads from where it started by entering the bloodstream. Cancer travels through blood vessels to other parts of the body.

The cancer started in other parts of the body:

  • When cancer spreads to another part of the body, it is called metastasis. Cancer cells divide from where they started (the primary tumor) and travel through the lymphatic system or blood.
  • Lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. Cancer enters the bloodstream, travels through blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • A metastatic tumor is a cancer of the same type as a primary tumor. For example, if nasopharyngeal cancer has spread to the lungs, the cancer cells in the lungs are actually nasopharyngeal cancer cells. The disease is metastatic nasopharyngeal cancer, not lung cancer.

Treatment for nasopharynx

There are a variety of treatments for children with the nasopharynx. Some treatments are standard (treatment currently in use), while others are being tested in clinical trials. Treatment A clinical trial is a research study that can help improve current treatments or obtain information about new treatments for patients with cancer.

When clinical trials show that the new treatment is better than the standard treatment, the new treatment may become the standard treatment. Since cancer is very rare in children, participation in clinical trials should be considered. Some clinical trials are open only to patients who have not started treatment.

Children with nasopharynx should have their treatment planned by a team of doctors who specialize in treating childhood cancer. Treatment is overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health professionals who specialize in treating children with cancer and who specialize in certain areas of medicine. This may include the following experts and others:

  • Pediatrician
  • Pediatric surgeon
  • Radiation Oncologist
  • Pediatric ear, nose, and throat specialist
  • Pathologist
  • Pediatric Nurse Specialist
  • Social worker
  • Rehabilitation specialist
  • Psychologist
  • Expert in child life

Four types of standard therapy are used:

Chemotherapy: Chemotherapy is the treatment of cancer using drugs to stop the growth of cancer cells by killing them or preventing them from multiplying. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and reach cancer cells throughout the body (systemic chemotherapy).

Radiotherapy: Radiation therapy is a cancer treatment that uses high-energy x-rays or other forms of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation to the area of ​​the body where the cancer is.

Surgery: Surgery to remove the tumor is done if the tumor does not spread through the nasal cavity and throat at the time of diagnosis.