Vertigo – a perception of movement where the person or the person’s surroundings appear to whirl dizzily – is, typically an undesirable event. Vertigo feelings can disrupt balance and contribute to falls that can be dangerous among older adults; it can also be accompanied by dizziness, sensations of spinning in space, and more rarely, nausea, vomiting, migraine headaches, visual abnormalities including nystagmus, and fainting.
There are many causes for vertigo, but one kind of it – benign paroxysmal positional vertigo, or BPPV – relates to your sense of hearing. The disorder is caused by calcium crystals that form naturally in the inner ear. Called otoliths or otoconia, these crystals usually cause no problems for people. For people who have BPPV, however, these crystals travel from their normal location into one of the semicircular canals of the inner ear, which are critical for our sense of balance. Once inside the semicircular canals, the crystals trigger an abnormal displacement of endolymph fluid each time a person alters the position of their head (relative to gravity). This is the underlying cause of the vertigo feelings in cases of BPPV.
BPPV is characterized by the episodic (paroxysmal) nature of the vertigo, and may be brought on by such common motions as tilting the head, looking up or down, rolling over in bed, or any other rapid head motion. The ensuing vertigo can be worsened by stress, lack of sleep, or changes in barometric pressure (for instance, just before a snowfall or rainfall). BPPV may appear at any age, but it’s most often observed in individuals over the age of 60. It is hard to determine the specific cause of benign paroxysmal positional vertigo for any given individual, however it generally develops after accidents in which the individual receives a blow to the head.
BPPV is differentiated from other varieties of vertigo or dizziness in that it is practically always brought on by head movements, and in that its symptoms usually subside less than a minute. Diagnosing benign paroxysmal positional vertigo generally involves a straightforward test where the affected individual lies on an examination table and tilts their head to the side or over the edge. More comprehensive tests can be used in certain cases including videonystagmography (VNG), electronystagmography (ENG) and magnetic resonance imaging (MRI). VNG and ENG test for abnormal eye movements while MRI is used to eliminate other possible causes of vertigo such as brain abnormalities or tumors.
There is no complete cure for BPPV, but it can be successfully treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use physical movements to shift the crystals to a position in which they no longer cause trouble.In rare cases (under 10%), if these treatments do not provide relief, surgery may be proposed. Visit your doctor if you have experienced symptoms that seem as if they could be related to benign paroxysmal positional vertigo, especially if they last for more than a week.