Getting to Know Benign Paroxysmal Positional Vertigo
Have you ever felt dizzy and everything around you felt like spinning, especially when you were looking up, lying on one ear, rolling over in bed, getting out of bed, or when bending over? If you have experience at least one of those above, you might have Benign Positional Paroxysmal Vertigo or BPPV. It might sound scary, but don’t worry. This article will explain further about BPPV and how it can be treated.
Benign Positional Paroxysmal Vertigo or BPPV is a type of peripheral vestibular disorder (peripheral vertigo). It affects the vestibular system that is located in the inner ear which is involved with the equilibrium4. That is why dizziness and motion sensation happen when BPPV occurs. It is the most common vestibular disorder; with lifetime prevalence is 2.4%1. Women are more affected and symptoms appear later in life mostly in the fourth or fifth decades of life3,5.
BPPV is usually brought when there is a sudden movement or changes in position. It occurs when there is a disturbance to the otoliths in the inner ear’s balance system. These are small crystals inside the inner ear which can become dislocated and cause symptoms of vertigo3. Some of the symptoms are dizziness, feeling light-headed, balance problems, and nausea. The dizziness usually begins seconds after a certain head movement and lasts less than a minute2.
A complete medical history and examination can be done to diagnose whether or not it is BPPV. One of the tests that is used to identify whether or not a person has BPPV is Dix-Hallpike maneuver. The Dix-Hallpike maneuver entails guiding a patient through a series of movements known to elicit rapid involuntary movement of the eyes (nystagmus) in a patient with BPPV5.
The right treatment for BPPV is important because most of people who are affected with BPPV will have spontaneous resolution of their symptoms after being treated. For those with persistent symptoms, the first line of treatment is Canalith Repositioning Maneuvers. These maneuvers attempt to reposition the free-floating canalith particles (otoliths) in inner ear using gravity5. However, in people who are not fit for Canalith Repositioning Maneuvers, pharmacotherapy (anti-vertigo) can be used as a treatment option5.
References
1. Von Brevern, M., Radtke, A., Lezius, F., Feldmann, M., Ziese, T., Lempert, T., & Neuhauser, H. (2007). Epidemiology of benign paroxysmal positional vertigo: a population based study. Journal of Neurology, Neurosurgery, and Psychiatry, 78(7), 710–715.
2. Department of Health and Human Services, State Government of Victoria, Australia. Vertigo (BPPV) Fact Sheet. (Updated 2010 December; cited 2018 May 28). Available from http://www.health.vic.gov.au/edfactsheets/downloads/vertigo-bppv.pdf.
3. Emergency Care Institute, New South Wales. Benign Paroxysmal Positional Vertigo Fact Sheet. (Updated 2012 May; cited 2018 May 28). Available from https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0003/274062/benign-paroxysmal-positional-vertigo-patient-factsheet.pdf.
4. Stanford Primary Care Clinics. Patients Information Benign Paroxysmal Positional Vertigo (BPPV). Available from http://sim.stanford.edu/resources/smg_patient_info/VERTIGO03-10.pdf.
5. Thompson, T. L., & Amedee, R. (2009). Vertigo: A Review of Common Peripheral and Central Vestibular Disorders. The Ochsner Journal, 9(1), 20–26.
6. Kaur Japneet and Shamanna Karthik. Management of Benign Paroxysmal Positional Vertigo: Comparative Study between Epleys Manouvre and Betahistine. 2017;21(1):30-34.
