BPPV: Benign Paroxysmal Positional Vertigo

Healthy Movement for Life
By: Dr. Jill Trato, DPT, NCS 

BPPV is a medical condition which occurs within the vestibular system. As its lengthy name indicates, it is not harmful, it comes and goes depending upon positional changes and the symptom experienced is vertigo or, the sense of spinning. 

Have you ever felt like you were spinning after lying down or rolling in bed? Or maybe when lying onto your back on a bench while at the gym? Did the spinning last less than one minute and then subside completely until the next time you performed a similar movement? This is the typical presentation of BPPV. Some people with BPPV can also experience nausea, vomiting and/or imbalance. Older adults with BPPV are three to four times more likely to fall than those without BPPV, especially when they have imbalance at baseline. 

BPPV is a mechanical problem which is caused when the otoconia becomes dislodged from its home and moves into a semicircular canal. When you move your head, the otoconia moves within the canal and excites that canal. This weights part of the system to gravity when it is not meant to be weighted to gravity. The end result is excessive excitatory input telling your brain that you are moving/turning when in fact, you are not. It typically takes about one minute for the otoconia to settle down and stop moving. At that time, the sensation of spinning and imbalance will go away. 

There is a clinical, bedside test called the Dix-Hallpike which can assist the clinician in determining if you have BPPV and if so, which ear (right or left) and which semicircular canal is affected. 

If you do have BPPV, a maneuver can be performed with the goal of moving the otoconia out of the semicircular canal and back into the otolith organ where they belong. It typically takes one to three repetitions of a maneuver to successfully treat BPPV. This means that all symptoms of vertigo with head/body positional changes resolve. 

If you are interested in learning more, give us a call at (805) 284 - 9449 to book a free consultation.