Patients with vertigo incorrectly perceive motion (commonly a rotating motion) in their surroundings. The sensations of vertigo occasionally include dizziness, spinning or falling. When vertigo affects balance, it can result in falls and accidental injuries – particularly in older adults. More serious cases of vertigo may also cause nausea, vomiting, migraines, visual irregularities called nystagmus and fainting spells.
There are various distinct forms of vertigo with different root causes. Audiologists frequently encounter benign paroxysmal positional vertigo, or BPPV, because it is related to your sense of hearing. BPPV is caused by naturally-forming calcium crystals in the inner ear called otoconia or otoliths, and which normally cause no issues. In BPPV, the crystals travel from their normal locations into the semicircular canals of the inner ear. When this occurs, and the individual with BPPV reorients their head relative to gravity, these crystals move about, and cause an abnormal displacement of endolymph fluid, which leads to vertigo.
Everyday movements such as looking up and down, tilting your head or rolling over in bed can bring about the benign paroxysmal positional vertigo. The vertigo sensation comes on very suddenly and has a short duration. These symptoms can be worsened by sleep disorders, stress, or changes in barometric pressure, such as before snow or rain. Although benign paroxysmal positional vertigo may start at any age, it’s more common in individuals over 60 years old. The initial trigger for the benign paroxysmal positional vertigo is generally hard to establish. A sudden blow to the head (such as in an automobile accident) is among the more well-known causes.
Benign paroxysmal positional vertigo differs from other types of dizziness or vertigo because the attacks are quite short (generally less than a minute), and because it is always prompted by movements of the head. Diagnosing BPPV commonly involves a simple test where the individual lies on an exam table and tilts their head sideways or over the edge. Additional tests which can be used to diagnose BPPV include videonystagmography or electronystagmography, which test for abnormal eye movement, and magnetic resonance imaging (MRI), primarily to eliminate other possible causes, such as brain abnormalities or tumors.
There’s no full cure for BPPV, but it can be effectively treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use bodily movements to shift the crystals to a position in which they no longer cause problems.Surgical treatment is a possibility in the rare cases where these treatments are ineffective. If you suspect benign paroxysmal positional vertigo or have been experiencing vertigo or dizziness for over a week, consult a specialist well-versed in vertigo and balance disorders.