Spotlight on Benign Paroxysmal Positional Vertigo

Today I would like to provide you with information on Benign Paroxysmal Positional Vertigo (BPPV). I feel that learning about BPPV is important because it is the number one cause of vertigo in the United States, as well as the most common disorder of the vestibular system of the inner ear. First, let's break down the medical terminology. Benign means that the disorder is not life-threatening, which is a good thing. Paroxysm means a sudden attack, positional means a change in position, and remember that vertigo is a spinning sensation.  

Putting it all together, BPPV is a non life-threatening disorder in which sudden episodes of vertigo occur that are caused by changes in the position of the head.

To help you understand how vertigo occurs, let's go over the anatomy of the inner ear and how it relates to balance. The anatomical structures in the inner ear that play a role in vertigo are the utricle, saccule, and three semicircular canals. 

The semicircular canals detect rotational movement and contain balance receptors. The three canals are placed at right angles from each other and allow us to know if our head is moving up-and-down, side-to-side, or titling. All three semicircular canals are filled with a watery fluid called endolymph. When the head moves, the endolymph fluid within the semicircular canals also moves, stimulating receptors to send information to the brain about the movement of the head. The ends of the semicircular canals are connected to the utricle which is connected to the saccule. Both the utricle and the saccule provide the brain with information on the position of the head. They also both contain tiny crystals of calcium carbonate called otoconia. 

Now that you have a better understanding of what is going on inside your inner ear, I will explain how vertigo occurs in the case of BPPV. If the crystals become dislodged from the utricle, they can move into the semicircular canals. Once in a semicircular canal, the crystals may clump together and form a larger mass. When the head moves, the clump of crystals can disrupt endolymph fluid movement, stimulating the sensory cells which then send false signals to the brain that the head is moving. Hence, vertigo is induced and you feel like you or your surroundings are spinning. 

In addition to vertigo, other symptoms of BPPV include unsteadiness, a loss of balance, nausea, vomiting, difficulty concentrating, and blurred vision. BPPV can be difficult to diagnose because there are many causes of vertigo and symptoms tend to be similar. It is most common in people over 60 but can occur at any age. The most common treatment options for BPPV are head repositioning maneuvers. There are several maneuvers that have been created and the most common one is the Epley maneuver. The goal of any head repositioning maneuver is to move the displaced otoconia out of the affected semicircular canal. For more information on the most common head repositioning maneuvers, follow the link here to my previous blog post on managing and treating vertigo. In rare cases, surgery may be recommended by your doctor. 

In this post I wanted to provide you with a brief overview on BPPV and teach you what exactly goes on inside your inner ear that induces vertigo. For more in depth information on BPPV, check out the following links:

• http://vestibular.org/understanding-vestibular-disorders/types-vestibular-disorders/benign-paroxysmal-positional-vertigo
• http://www.mayoclinic.org/diseases-conditions/vertigo/basics/definition/con-20028216
• http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/conditions/benign_paroxysmal_positional_vertigo.html

If you suspect you have experienced vertigo, make sure to see your doctor to receive a proper diagnosis. It is likely you might have Benign Paroxysmal Positional Vertigo since it is the most common cause of vertigo in the United States. If you are diagnosed with BPPV remember that it is not life-threatening and highly treatable.   

Handling a Vertigo Episode

In a previous blog post, titled How to Manage and Treat Vertigo, I discussed treatment options and ways to prevent another vertigo episode from happening. Although the goal of someone suffering from vertigo is to prevent the occurrence of episodes, it is important to know what to do if a vertigo episode strikes, whether it is you or someone you know experiencing symptoms. 

If you feel that a vertigo episode is beginning (you feel like you are spinning), the first thing you should do is try to stay still and sit down slowly. You will want to avoid any quick movements because you might fall and injure yourself or make symptoms worse. If you are with someone, you should let them know how you are feeling, but if you are alone, you should try your best to concentrate and move slowly to sit down. If you are in a public place, you could find a wall to lean against or find a place to sit down and rest until symptoms subside. 

During a vertigo episode, it is also best to avoid moving your head and looking up or down as this could cause further disorientation. You should try to keep your head level and parallel to the ground. If you are at home or you can find a bench, it is sometimes helpful to lay down. Sitting or laying down can also help if you feel nauseous. Another tip is to focus on a distant object, which can help you concentrate and reduce feelings of dizziness. 

If someone you know is experiencing vertigo, you can help them follow the tips above and alleviate their symptoms. If someone tells you they feel like they or their surroundings are spinning, you should help them find a place to sit or lie down. Guide them slowly to a place to sit and try to keep them steady. You can help them relax by reassuring them their symptoms will most likely subside shortly since most episodes only last a few minutes. 

Following these tips can help you or someone you know endure a vertigo episode with minimal stress and anxiety. In addition, they can help alleviate symptoms, thereby reducing the length of an episode.