Benign Paroxysmal Positional Vertigo, or BPPV, refers to the degeneration of the inner ear, becoming a growing concern for ageing individuals. BPPV stands out as the leading cause of vertigo, a sensation where one feels their surroundings spinning uncontrollably.

Causes of BPPV

The primary cause of BPPV lies in the displacement of calcium carbonate particles, also known as otoconia or balance crystals, inside the inner ear. When individuals with this condition shift their heads, these particles move inside the balance canal, eliciting a vertigo response.

Recognising the Symptoms of BPPV

Individuals with BPPV often report feeling:

  • An abrupt sense of the world spinning around when changing head positions, such as lying down, standing up, rolling over, or bending.
  • This sensation of dizziness is fleeting and usually diminishes gradually after a head movement.
  • Vertigo spells can be recurrent, but often with diminishing intensity.
  • In severe cases, individuals might experience nausea or even vomiting.
  • Vertigo might manifest several times within a day. While it usually sees a reduction over weeks to months, there's a possibility of recurrence after prolonged periods.

How BPPV is Diagnosed

To diagnose BPPV, medical professionals rely on:

  • A comprehensive history of symptoms.
  • Physical evaluations, inclusive of the ear, nose, throat, and neurological system.
  • The Dix-Hallpike manoeuvre: This diagnostic test involves the patient lying down swiftly with a tilted head. A positive BPPV test is marked by observable eye jerks accompanying vertigo.
  • Hearing tests.

Available Treatment Options for BPPV

  1. Lifestyle Adjustments: Primarily involves evading positions and activities that trigger symptoms. While there are medicines to manage dizziness, no current medication can entirely cure BPPV. Nonetheless, for the majority, symptoms naturally wane after the initial month.
  2. Physical Therapy: At present, this is a potent treatment avenue. This includes:
    • Canalith repositioning therapy like Semont, Epley, and Lempert (BBQ) Maneuvers.
    • Vestibular compensation exercises like Brandt and Daroff, assisting the brain in regaining balance control.
  3. Surgical Intervention: If neither medication nor physical therapy brings relief, surgery might be the recommended course of action.