What is Benign Paroxysmal Positional Vertigo?
Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo/dizziness. It is an inner ear disorder which is caused by movement of otoconia (calcium carbonate crystals), in response to gravity within the semi-circular canals (part of your balance organ). Everyone has otoconia within the balance organs, but these are normally situated within two otololith organs called the utricle and saccule. If the otoconia move to the semi-circular canal, changes in position can result in an involuntary eye movement called nystagmus.
Why does it happen?
BPPV can happen spontaneously without any causes, however, it can be triggered by trauma such as a fall or road traffic accident. This trauma can cause the otoconia to move out of the otolith organs and into the semi-circular canal. The resulting involuntary eye movements (nystagmus) can result in symptoms of vertigo. BPPV is more common in people with pre-existing vestibular problems, women and in later life.
What are the symptoms?
BPPV can cause symptoms of vertigo (a sense of spinning of yourself or the environment) or loss of balance/dysequilibrium. The symptoms are often brief in nature (lasting for less than 2 minutes) and are triggered by changes in position such as lying down, bending over, looking up or rolling in bed.
What does a Physiotherapy assessment involve?
In order to test for BPPV, the Physiotherapist will complete an examination to assess for the presence of otoconia within the semi-circular canals. Tests can include the Dix-Hall Pike, Side-lying and roll test. The Physiotherapist will then look at the nature of the nystagmus to determine which canal the calcium carbonate crystals are in. These tests can reproduce your symptoms.
How can Physiotherapy treat BPPV?
Physiotherapists who specialise in Vestibular rehabilitation, are trained to complete canal repositioning manoeuvres. These utilise gravity and your head position to help to remove the otoconia from the semi-circular canal. A common canal repositioning manoeuvre is called the Epley manoeuvre.
Comments