When a person suddenly feels unsteady or suddenly feels like their surrounding are moving and they are standing still, they are likely experiencing vertigo. It may cause a feeling of being spun around on a merry go round or the head may feel like it is spinning all on its own. One of the more common disorders that is known to cause vertigo is called benign paroxysmal positional vertigo, or BPPV.
Benign paroxysmal positional vertigo is often classified by short, brief episodes of dizziness ranging in severity, from mild to intense, and it is associated with the specific changes that are made to the position of the head.
More often than not, it will occur when a head has moved in a certain direction, when a person lies down after being upright, when they turn over in bed or when they sit up in the morning. Moving the head either to look up or to look down are also likely to cause the symptoms and signs of benign paroxysmal positional vertigo. Sometimes a person may not feel within balance when they are walking or standing.
Benign paroxysmal positional vertigo, though a rather bothersome condition, is very rarely a serious one except when the severity increases the likelihood of falling.
During a visit to the doctor, a person can easily obtain effective treatment for their benign paroxysmal positional vertigo.
Symptoms of Benign Paroxysmal Positional Vertigo
Some of the symptoms and signs of benign paroxysmal positional vertigo might include:
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- A sense that the person or their surrounds are moving or spinning (vertigo);
- The loss of balance;
- Blurred vision that is associated with the feeling of vertigo;
- Nausea; and
The symptoms and signs of benign paroxysmal positional vertigo are likely to come and go, and the symptoms generally do not last any longer than a minute. Some episodes of benign paroxysmal positional vertigo, as well as its other forms, may disappear for awhile before then recurring later on.
The activities and plans that bring on the symptoms and signs of benign paroxysmal positional vertigo are likely to vary between each affected person, but it is almost always caused by changing the position of the head.
Nystagmus, which is the abnormality in rhythmic eye movement, is likely to accompany the symptoms present in benign paroxysmal positional vertigo. Though this is a rare occurrence, it is still possible for a person to have benign paroxysmal positional vertigo in both of the ears, which is bilateral BPPV.
Causes of Benign Paroxysmal Positional Vertigo
Deep inside the ear lays a little organ that goes by the name of the vestibular labyrinth. This is made up of structures made of loops, or the semicircular canals, that contain both fluid and sensors that are fine and hair-like, which serve to detect the rotation that occurs with the head.
Other structures, particularly the otolith organs, that are found within the ear also monitor how the head is moved and the position of the head. The organs contain crystals that allow a person to be sensitive to movement. There are many reasons why these crystals become dislodged.
When this happens, it may move into one or more of the semicircular canals, and this is very likely to happen when a person lays down. Because the crystals do not belong in the semicircular canals, they become ultra-sensitive to the way the head changes position, especially those that they would otherwise not notice or respond to. The end result is dizziness.
Who it Effects
Most cases of benign paroxysmal positional vertigo happen in people who are over the age of 60 years. However, it is also possible to develop it after receiving either a minor or a severe blow to the head. Other causes are possible, such as taking damage to the inner ear or, much more rarely, taking damage when in the process of ear surgery or during a prolonged positioning while on the back, or supine.
Sometimes, doctors are capable of figuring out what is causing benign paroxysmal positional vertigo. This may require that an ENT specialist, who deals with ears, noses and throats, or a neurologist, who deals with the brain and the nervous system, provide a consultation. However, it is almost equally common for a doctor to determine that no specific cause can be blamed.
Risk Factors For Benign Paroxysmal Positional Vertigo
No definitive factors seem to exist that effectively increase a person’s risk of developing benign paroxysmal positional vertigo, with the exception of natural aging. However, a person may be susceptible to developing benign paroxysmal positional vertigo if they received a prior head injury or suffered any other kind of disorder with regards to the balance organs that are present in the ear.
When to Seek Medical Advice
Anybody who is experiencing vertigo or dizziness that cannot be explained and periodically recurs for over two weeks should see their doctor. Though it is not very common for dizziness to signal some kind of serious illness,
- a new, severe or different headache;
- a fever of 101 degrees Fahrenheit, or 38 degrees Celsius, or higher;
- loss of vision or double vision;
- hearing loss;
- trouble speaking;
- weakness in the arms or legs;
- loss of consciousness;
- difficulty walking or falling;
- tingling or numbness; or slow or rapid heart rate or chest pain.
When combined with one of the above symptoms and signs, dizziness or vertigo may be signaling a much more serious problem, such as heart disease, stroke, Parkinson’s disease, brain tumor or multiple sclerosis.
Tests and Diagnosis
When the doctor is undergoing examination, he or she may wish to conduct a series of different tests in order to figure out what is causing the dizziness. During a physical examination, the doctor will most likely look for:
The ability to control movements of the eye;
- symptoms and signs of any dizziness that occur by moving the head or eye and then its decrease within one minute;
- nystagmus, which is the involuntary movement of the eyeballs from side to side; and
- dizziness with certain eye movements which occur when a person lays down onto their back and with their head turned to the side
If it is difficult to tell what is causing the symptoms and signs, there may be further tests ordered, including:
Electronystagmography (ENG) or videonystagmography (VNG).
This test is completed to check for any unnatural movement of the eyes. The ENG would be completed with electrodes and the VNG would be completed with tiny cameras, and both would be capable of determining whether the dizziness is being caused by inner ear disease.
They do so by measuring and monitoring the involuntary eye movements of a person while the head is positioned in various different ways or the balance organs are stimulated using air or water. There exist other tests that are capable of determining a person’s ability to keep upright under both easy and under difficult conditions.
Magnetic resonance imaging (MRI).
As the name implies, this test makes use of radio waves and a magnetic field in order to create images that are cross sectional of both the head and body of a person. These images can be used by a doctor in order to identify and properly diagnose a whole wealth of different conditions.
The MRI may be recommended in order to rule out the chance of acoustic neuroma, which is a noncancerous brain tumor of the nerve that is responsible for carrying out both sound information and balance information to the brain from the inner ear – or any other similar lesions that may be causing the vertigo.
Complications of Benign Paroxysmal Positional Vertigo
Despite the fact that benign paroxysmal positional vertigo is a generally uncomfortable condition, it does not often cause people to develop complications. However, should the condition be severe and persistent, it may cause a person to frequently vomit, and this will put them at the risk of becoming greatly dehydrated.
Treatments and Drugs
In an effort to relieves the symptoms of benign paroxysmal positional vertigo, the doctor, audiologist or physical therapist may wish to offer treatment by way of the canalith repositioning procedure, which is a series of therapeutic movements.
This is performed in the doctor’s office, and it generally consists of slow, simple maneuvers in order to reposition the head. The primary goal is to gently move the particles that have fallen into the fluid filled semicircular canals located within the inner ear and move them into an open area that is tiny, vestibule, which is where the otolinth organs (utricle) are stored.
Were the particles to re-enter the utricle, it would no longer cause any troubles and it would be reabsorbed much more easily. Every position must be held for about 30 seconds once any abnormal eye movements or any symptoms cease. Most people find the treatment to be effective after the first or second time.
After the completion of the procedure, the person is to avoid lying completely flat or from letting the treated ear fall below shoulder level. For the night of the treatment, a person should ensure that they elevate their head using several pillows at the time of sleeping.
This will allow an appropriate amount of time for the particles that are still floating around within the labyrinth to fully settle into the vestibule, allowing it to be reabsorbed in the inner ear by the fluids. This procedure may require repeat performances for a few days afterwards. For this reason, chances are good that a person will be taught how this procedure is to be performed so that they may do it on their own prior to making an appointment for a checkup.
Sometimes, though this instance is very rare, the canalith repositioning procedure may prove to not be very effective, the doctor may instead recommend that a person undergo a certain surgical procedure, which would include taking a bone plug and blocking off a section within the inner ear that is causing the dizziness to occur.
The plug will disallow the semicircular canal, found within the inner ear canal, to respond to head movements or particle movements. Roughly 90 percent of people achieve success undergoing the surgery for canal plugging. Under five percent of people who take on this procedure end up experiencing some level of long term hearing loss.
Lifestyle and Home Remedies
For those who are suffering dizziness due to benign paroxysmal positional vertigo should take these tips to heart:
- Know that dizziness may cause a person to lose their balance, which can lead to both falling in addition to serious injury.
- When feeling dizzy, immediately sit down.
- If making a movement that usually causes illness, try to move slowly.
- If getting up at night, try to use good lighting.
- Those who are at risk of falling and seriously injuring themselves should consider walking with a cane for stability.
- Try to work closely with a doctor in order to effectively manage the symptoms
- Coping and Support For Benign Paroxysmal Positional Vertigo
It can be a challenge to live with benign paroxysmal positional vertigo, affecting the way a person interacts with both friends and family, affecting productivity at work and overall affecting the quality of their life. However, there exist many a support group for those dealing with the same condition, who can offer encouragement and understanding.
Support groups may not be for everybody, but they can be a great source of information. Members of a group are often in the know with regards to unique coping skills and are always willing to share their own personal experiences with their condition. A doctor may be able to recommend a local group for benign paroxysmal positional vertigo within the area.