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what is bppv

Causes of Vertigo: What is BPPV?

You’ve heard of vertigo and dizziness, but what is BPPV (Benign Paroxysmal Positional Vertigo)? And why is it a mouthful? With this blog, we’ll answer that question, show you the signs and symptoms, and give you some remedy tips for when the balance issues get really bad. We will break BPPV symptoms and treatments down so you know what to look for. 

So, what’s the difference between this BPPV and vertigo?

It’s not that there’s a difference, it’s that BPPV is a primary cause of vertigo (Mayo Clinic Staff, 2020). This cause and effect is actually very common and is usually not harmful or a sign of an underlying disease. BPPV deals more with your head movement and position. 

A good example of this is when you sit up or sit down too quickly and you feel that sense of dizziness or unsteadiness. The good news is that this form of vertigo only lasts less than a minute. Anything lasting longer than that or in more abnormal circumstances could be something else entirely. 

A Study in BPPV

Some time ago, NCBI recorded a group study, which gathered interesting results regarding BPPV. The objective was, “To examine the prevalence and incidence, clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population.” 

They screened 4,869 patients for severe dizziness and vertigo to determine if BPPV was the primary culprit. 

The results? Here’s a list: 

  • BPPV was responsible for 8% of the population of the group
  • 86% of the group members sought medical consultation, lacked regular function, or took sick leave because of symptoms
  • …age, migraine, hypertension, hyperlipidaemia and stroke were independently associated with BPPV.
  • Benign paroxysmal positional vertigo (BPPV) is probably the most common cause of vestibular vertigo accounting for approximately 20–30% of diagnoses in specialised dizziness clinics.1,2 The evolution of highly effective positioning manoeuvres3,4 has made BPPV the most successfully treatable cause of vertigo.

Conclusion: BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact and medical costs.

Other Causes of BPPV

Outside of the most common cause, head movement, there are a few other reasons BPPV kicks in and makes us dizzy. 

According to the Mayo Clinic, “When there is a known cause, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or long periods positioned on your back, such as in a dentist chair. BPPV also has been associated with migraines.

More specifically, trauma is a common cause amongst younger people. BPPV naturally tends to be more common in older people (Hain, 2020). 

Other causes include migraines, post-procedure recovery (related to head position and vibrations of procedural tools), and viruses that affect the workings of the inner ear. 

How is BPPV diagnosed and treated?

 According to these sources used, BPPV isn’t something that’s life-threatening, so waiting out the symptoms is a viable option. These symptoms can last up to a couple of months, so getting diagnosed and treated depends on the severity of symptoms and if they affect a person’s ability to function.

At our facilities at the Ear, Nose & Throat Institute, the physical therapists use a variety of technologies and techniques to diagnose and treat. Allison Robbins, the Director of Physical Therapy here says, “Our physical therapists use video Frenzel nystagmography to determine the cause of dizziness and imbalance. Use of Frenzel goggles allows us to determine the underlying cause by assessing the function of the inner ear and central motor function.” (Robbins, 2020).

Frenzel goggles

Regarding balance and the workings of the inner ear, there are separate tools for that too. 

Allison continues with, “The computerized dynamic posturography is an objective method of testing balance. It helps determine IF and WHY a person is at risk for falls. This highly sophisticated technology differentiates the sensory systems that control balance including visual (input from eyes), vestibular (input from the inner ear), and somatosensory (input from muscles, bones, and joints). It is a valuable tool that analyzes sensory, motor, and central adaptation to determine underlying impairments.

Remedies for BPPV

If you’re someone who wants to wait it out and see where it goes, there are a few methods for reducing symptoms temporarily, but it’s important to note that physical therapy is the best option for long-term relief. 

A physical therapist will also be able to determine which methods are best for you and your individual needs. 

This list comes from WebMD regarding vertigo maneuvers, or positions, that help with the severity of symptoms. 

Movements for Vertigo:

  • Epley – Left ear
  • Semont – Left ear, though not as popular as Epley
  • Foster – Half-somersault 
  • Brandt-Daroff 

Click the button below to learn how to do these exercises. 

Despite BPPV being rather mild in terms of health risk, it’s still beneficial to get diagnosed and treated. For some, BPPV can have a more severe threshold, relegating them to minimal daily tasks. If this is you or a loved one, don’t fret. The ENT Institute takes patients same-day and even walk-ins. 

To schedule an appointment, call 770-740-1860 or click the button below.

Citations

  • Mayo Clinic Staff (2020, August 18) Benign paroxysmal positional vertigo (BPPV) [Medical Website] Retrieved on October 20th, 2020 from https://www.mayoclinic.org/diseases-conditions/vertigo/symptoms-causes/syc-20370055#:~:text=Benign%20paroxysmal%20positional%20vertigo%20(BPPV)%20is%20one%20of%20the%20most,changes%20in%20your%20head’s%20position.

  • Hain, T, MD. (2020, October 12) BPPV–Benign Paroxysmal Positional Vertigo [Medical Blog] Retrieved on October 20th, 2020 from https://dizziness-and-balance.com/disorders/bppv/bppv.html

  • Robbins, A., (2020) How We Diagnose and Treat Your Dizziness and Vertigo [Medical Blog] Retrieved on October 22nd, 2020 from https://entinstitute.com/treat-dizziness-vertigo/J Neurol Neurosurg Psychiatry. 2007 Jul; 78(7): 710–715. Published online 2006 Nov 29. doi: 10.1136/jnnp.2006.100420

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