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
- 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:
- Blurry vision
- Mild headache
- Loss of balance
The most common symptoms can include:
- The feeling of the room spinning
- 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.
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.
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.