By Mapula Mokwena, Clinical Audiologist

What is BPPV? 

Benign Paroxysmal Positional Vertigo (BPPV) is the most common inner ear problem and cause of vertigo (vertigo is a false of spinning). It is more common in older people. 

Each word describes the condition: 

• Benign- means it is not life-threatening even though the symptoms can be very intense and upsetting. 
• Paroxysmal- it comes in sudden, short spells. 
• Positional- certain head positions or movements can trigger a spell. 
• Vertigo- feeling like you are spinning or the world around you is spinning. 

 

What causes BPPV? 

The majority of BPPV cases are spontaneous. Although BPPV episodes can happen to anybody, they are more common in older adults. Trauma, migraine, other inner ear issues, diabetes, osteoporosis, and prolonged bed rest (either side of the favoured sleep side, medical procedures, or illness) are occasionally linked to it. Our inner ears contain calcium carbonate crystals that aid in balance and movement. These microscopic “otoconia,” or rock-like crystals, are located in the middle “pouch” of our inner ears. The crystals becoming “unglued” from their usual location is what causes BPPV. They may become lodged on sensors in the incorrect area or canal of the inner ear as they drift around. The crystals being out of place are the source of BPPV symptoms.

What are the common symptoms of BPPV?

Although every person’s experience with BPPV is unique, there are some common symptoms:

• Distinct triggered spells of vertigo or spinning sensations.
• Severe feeling of disorientation in space or instability

These will be severe symptoms for a few seconds to several minutes. After the episode is over, you may continue to feel unsteady and lightheaded, although to a lesser extent. Some individuals, particularly those who are elderly, may experience BPPV more as a solitary feeling of unsteadiness that occurs when shifting head or body positions. This sensation can be elicited by reaching, leaning over, sitting up, and looking up. BPPV is sometimes brought on by movement and does not always result in extreme dizziness. BPPV does not impair hearing or make you dizzy. The BPPV-related dizzy episodes can raise your risk of falling. 

What treatments are available? 

The majority of BPPV cases can be resolved with bedside repositioning techniques, which your audiologist/ healthcare professional will carry out. It normally just takes a few minutes to finish these treatments. Approximately 80% of patients get success with them, however occasionally multiple treatments may be required.

How long will it take before I feel better? 

You may feel dizzy, nauseated, and disoriented for a short while during the BPPV therapy. Some patients report that their symptoms immediately go better after receiving treatment. Others report to still experience slight instability and feelings similar to motion sickness. Successful BPPV treatments may not completely eliminate your sensitivity to movement. It may take a few days to many weeks for these symptoms to gradually fade gone. It’s critical to resume your regular activities as soon as your symptoms start to gradually go gone. Your healing process will accelerate if you are exposed to movement and motion. Talk to your audiologist/ healthcare professional about these activities. Exercises may be necessary for the elderly who have fallen in the past or who are afraid of falling.

Can BPPV come back?

Unfortunately, BPPV is a condition that occasionally recurs. Your lifetime risk of BPPV recurrence may change from low to high, depending on a variety of factors. These factors may include trauma (physical damage), aging, other inner ear disorders, or other medical issues. Although there is currently no known way to prevent BPPV from reoccurring, there are effective treatment options available. It is imperative that you consult your healthcare professional again if your symptoms persist. In order to confirm your diagnosis and/or go over other treatment choices, you can be referred for additional testing.

*Blog adapted from 

https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599816689671