Patients with vertigo incorrectly experience motion (often a rotating motion) in their environment. The feelings of vertigo sometimes include dizziness, falling or spinning. Any time vertigo affects balance, it may lead to falls and personal injuries – chiefly among the elderly. More extreme cases can also trigger nausea, vomiting, migraines, visual irregularities called nystagmus and fainting.
There can be many root causes for vertigo, but one variety of it – benign paroxysmal positional vertigo, abbreviated BPPV – is related to your sense of hearing. Benign paroxysmal positional vertigo occurs from calcium crystals that form naturally known as otoconia or otoliths, which usually cause no issues. In BPPV, the crystals travel from their normal locations into the semicircular canals of the inner ear. When this happens, and the person with benign paroxysmal positional vertigo changes the orientation of their head relative to gravity, these crystals move about, and cause an abnormal displacement of endolymph fluid, which leads to vertigo.
Everyday motions such as tilting your head, looking up and down or rolling over in bed can trigger the BPPV. The vertigo sensation comes on very quickly and has a short duration. These symptoms can be made worse by lack of sleep, anxiety, or changes in barometric pressure, such as before rain or snow. The disorder can present itself at any age, however it most commonly appears in individuals over 60 years of age. The initial trigger for the BPPV is typically hard to pinpoint. An unexpected blow to the head (such as in a motor vehicle accident) is among the more common causes.
BPPV is differentiated from other varieties of vertigo or dizziness in that it is nearly always brought on by head movements, and in that its symptoms usually decrease in less than a minute. Diagnosing BPPV typically involves a simple test where the affected individual lies on an exam table and tilts their head sideways or over the edge. Other tests which can be used to diagnose BPPV include electronystagmography (ENG) or videonystagmography (VNG), which test for abnormal eye movement, and magnetic resonance imaging (MRI), primarily to rule out other possible causes, such as brain abnormalities or tumors.
There’s no full cure for benign paroxysmal positional vertigo, but it can be effectively treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use bodily movements to guide the crystals to a position in which they no longer cause trouble.Surgical treatment is an option in the rare cases in which these treatment methods are not effective. If you’ve experienced unexplained vertigo or dizziness that lasts for more than a week, see your health care provider.