What is BPPV – B.P.P.V known as Benign Paroxysmal Positional Vertigo. It is a common disorder of the inner ear that causes brief episodes of vertigo (a spinning sensation) triggered by certain head movements or changes in position.
BPPV occurs when tiny calcium crystals called otoliths, or sometimes referred to as canaliths, become dislodged from their usual position within the inner ear and migrate into one of the fluid-filled canals.
The inner ear plays a very important role in maintaining balance and spatial orientation.
The movement of these displaced crystals in the fluid-filled canals disrupts the normal flow of fluid, leading to false signals being sent to the brain about the body’s position and movement.
This mismatch between the signals from the inner ear and other sensory inputs
such as vision and proprioception, results in the characteristic symptoms of BPPV.
The most common symptoms of BPPV include brief episodes of dizziness or vertigo that are triggered by certain head movements, such as rolling over in bed, tilting the head backward, or looking up.
The vertigo typically lasts for less than a minute but can be quite intense.
BPPV Symptoms
Other symptoms may include lightheadedness, imbalance, nausea, and sometimes vomiting.
BPPV can often be diagnosed based on the characteristic symptoms and a physical examination.
Fortunately, BPPV is generally a benign condition, as the name suggests. It can be effectively treated with specific head and body movements known as canalith repositioning procedures or particle repositioning maneuvers.
These maneuvers aim to guide the dislodged crystals out of the affected canal and into a different part of the inner ear where they do not cause symptoms.
In some cases, medication may be prescribed to alleviate symptoms or manage associated nausea.
If you suspect you have BPPV or are experiencing symptoms of dizziness or vertigo
it is advisable to consult a concerned Qualified Doctor.
such as an otolaryngologist or an audiologist, for proper diagnosis and appropriate treatment.
Benign Paroxysmal Positional Vertigo Diagosis
The diagnosis of Benign Paroxysmal Positional Vertigo (BPPV) typically involves a combination of a thorough medical history, physical examination and specific diagnostic tests.
Medical History:
The healthcare professional will begin by asking you detailed questions about your symptoms
such as the frequency, duration and triggers of vertigo episodes.
They will also inquire about your medical history, any recent head injuries and the use of certain medications that could potentially affect balance.
Physical Examination:
A physical examination – To assess your balance, coordination and eye movements.
The Doctors may perform tests to evaluate your ability to maintain balance while standing, walking, or changing positions.
They will also look for any specific eye movements, called nystagmus, that can occur during an episode of BPPV.
Dix-Hallpike Maneuver:
This is a diagnostic test specific to BPPV. During the Dix-Hallpike maneuver, you will be seated upright with your head turned to one side.
Then Doctors will help you lie back quickly with your head extended over the edge of the examination table, while they observe your eye movements.
This maneuver is design to provoke vertigo and nystagmus
If BPPV is present and the type and direction of eye movements can help determine the affected ear.
Supine Roll Test:
In some cases, the Dix-Hallpike maneuver may not be conclusive.
In such situations, doctors can perform supine roll test also .
This involves lying flat on your back and then turning your head quickly to one side, while the healthcare professional observes any resulting nystagmus.
These tests aim to reproduce the characteristic vertigo and eye movements associated with BPPV.
Based on the findings, the healthcare professional can make a diagnosis and determine the affected ear and specific canal involved.
Itis important to note that proper diagnosis and differentiation from other conditions causing similar symptoms.
such as vestibular migraine or Meniere’s disease, require the expertise of a healthcare professional, typically an otolaryngologist or an audiologist.
They will be able to perform the necessary tests, interpret the results and provide appropriate treatment recommendations tailored to your specific condition.
BPPV Physiotherapy Treatment
Physiotherapy can be highly effective in the treatment of Benign Paroxysmal Positional Vertigo (BPPV).
The main goal of physiotherapy for BPPV is to reposition the displaced calcium crystals (otoliths)
within the inner ear and alleviate the associated vertigo symptoms.
The following are the possible Physiotherapy treatments for BPPV:
Canalith Repositioning Maneuvers (CRM):
Canalith repositioning maneuvers, also known as particle repositioning maneuvers
aim to guide the dislodged otoliths out of the affected canal and back into a different part of the inner ear where they do not cause symptoms.
The most widely used CRM is the Epley maneuver, but other maneuvers like the Semont maneuver or Brandt-Daroff exercises may also advice.
These maneuvers involve a series of specific head and body movements performed under the guidance of a trained physiotherapist.
The goal is to move the crystals through the affected canal and into a position where they no longer provoke vertigo symptoms.
Home Exercise Program:
Following the initial treatment session with a physiotherapist, they may provide you with a customized home exercise program to continue the canalith repositioning maneuvers on your own.
It is essential to strictly follow the instructions provided by the physiotherapist to ensure the effectiveness of the exercises and avoid any complications.
Vestibular Rehabilitation:
In addition to the canalith repositioning maneuvers, vestibular rehabilitation exercises may recommend to improve overall balance and reduce dizziness.
These exercises are design to promote central nervous system compensation for the inner ear imbalance and enhance the brain’s ability to adapt to changes in vestibular function.
Education and Lifestyle Modifications:
Physiotherapists can also provide education and guidance on lifestyle modifications to manage BPPV effectively.
They may advise you to avoid specific head positions or movements that can trigger symptoms.
They may also provide strategies for coping with vertigo episodes and minimizing their impact on daily activities.
It is important to consult with a qualified physiotherapist who has experience in vestibular rehabilitation and the treatment of BPPV.
They can assess your condition, determine the most appropriate treatment approach and guide you through the necessary exercises and maneuvers.
Additionally, they can monitor your progress and make any necessary adjustments to your treatment plan.