If you’re feeling unexpected bouts of dizziness, you may be experiencing a condition known as benign paroxysmal positional vertigo (BPPV). This condition is characterized by a sudden onset of feeling as if the room is spinning. It is the most common cause of vertigo.
BPPV Overview
If you are experiencing benign paroxysmal positional vertigo (BPPV), short episodes of dizziness may occur when your head’s position changes. The intensity of these episodes may vary from mild to extreme. Although it can be irritating or inconvenient, it is rarely a serious condition. However, it may elevate the risk of falls. If you are concerned, discuss with your doctor to create a treatment plan.
BPPV Symptoms
The signs and symptoms of BPPV may include the following:
- Sudden dizziness
- Feeling as if you or your environment are spinning or moving (also known as vertigo)
- Losing balance
- Unsteadiness
- Nausea or vomiting
You may also experience abnormal eye movements alongside these symptoms. These movements are called nystagmus.
These symptoms usually last no more than a minute. They can happen frequently over a short period of time. These episodes may disappear for a while and then return.
There are many activities that could trigger a BPPV episode, but they almost always begin with a change in head position, such as dizziness when lying down or moving it in a certain way. It may also occur when standing suddenly or while walking.
When Should I See a Doctor?
If recurrent, sudden, intense, or extended dizziness is causing you concern, see your doctor to discuss your next steps.
When to Seek Emergency Support
Vertigo rarely indicates a serious condition. However, when dizziness occurs alongside any of the following symptoms, seek medical care immediately:
- New, Sudden, Unexplained Headaches, Especially if Severe or Different Than Your Usual Experiences
- Fevers of 100.4 or More
- Vision Loss
- Double Vision
- Hearing Loss
- Difficulty Speaking
- Limb Weakness
- Loss of Consciousness
- Frequent Falling
- Trouble With Walking
- Numbness or Tingling in Your Body
Vertigo combined with any of these symptoms may be a sign of a more serious condition.
BPPV Causes
BPPV is a disorder that originates in the inner ear. Small calcium crystals known as otoconia move away from where they are usually located on the utricle. The free-floating crystals make their way into the inner ear, including the part of the ear that senses movement. This part of the ear is called the semicircular canal, or SCC. Otoconia in the SCC will not cause any problems until the head is moved. Such movements will cause fluid to flow in the SCC, which then stimulates the nerves that control balance and equilibrium.
Some of the movements that can result in this include moving your head from side to side or nodding, sitting up from a prone position, or rolling over in bed – causing dizziness when laying down.
BBPV usually has no recognized overarching cause. When no such cause is evident, the condition is known as idiopathic BPPV. Idiopathic means that a condition arises spontaneously.
If there is a known cause, it is usually due to trauma to the head. This could result from a blow ranging from fairly insignificant to severe. Other causes may be inner ear-related conditions or damage sustained during surgery. Long stretches of time spent on your back may also contribute to BPPV, such as time in a dentist’s chair. You can seek support at AICA Orthopedics in College Park, GA, to receive treatment for back pain as an option for dealing with your BPPV issues.
Risk Factors
BPPV can occur in any one of any age, but it most often affects people aged over 50. It is two to three times more common in women than in men. It is also more likely to affect you if you have had head trauma or any other disorder that affects balance and the inner ear.
BPPV Treatment
Fortunately, BPPV is relatively easy to treat. 90% of patients seem to benefit from procedures that move the free-floating particles back to where they belong in the utricle.
Epley Maneuver
The manipulation of crystals is called the Epley maneuver. It is a successful, non-invasive, non-medicated procedure that can be implemented with the support of a physical therapist.
The maneuver works by positioning the head in a particular sequence that helps the crystals float out of the semicircular canal. You may need to try several different positions in the same visit for the maneuver to be successful.
The steps to the Epley maneuver are as follows:
- Turn your head 45 degrees in the direction of the ear that is causing vertigo.
- Lay prone with your head over the side of the examination table for at least 30 seconds.
- Turn your body to the opposite side while keeping your head where it is.
- Turn your body and your head at the same time.
- Sit up carefully.
- Repeat up to six times until the dizziness has gone away.
You should always seek support from a medical professional to ensure that the maneuver is implemented correctly and to monitor for any other more serious factors.
Other Forms of Treatment
Medication is not normally prescribed to help with BPPV. However, anti-nausea medications may be helpful in the event of severe nausea or vomiting as a side effect of BPPV. This is particularly true in cases where the Epley maneuver would not be viable without managing nausea first.
Surgery is rarely necessary for treating this condition. If BPPV is recurrent to the point where it poses a threat to your continued safety, such as in the case of elevated risk for falls, your doctor may recommend a surgical procedure for more permanent manipulation of the posterior semicircular canal to limit the movement of crystals.
About half of people who have experienced BPPV are likely to have a recurring experience. There are home exercises that can help you manage it.