Feeling dizzy? Let's learn about Benign Proximal Vertigo (BPPV)!

Imagine you're trying to get out of bed in the morning, or rolling over on the other side of the bed. Suddenly, you feel like the whole room is spinning around you. Isn't that a very unpleasant and scary experience? This is the main symptom of a condition we call BPPV for short. It may sound like a big deal, but don't be afraid. Let's talk about this simply and clearly.

Simply put, what is BPPV?

The full meaning of BPPV is Benign Paroxysmal Positional Vertigo . The name sounds a bit long, doesn't it? Let's break it down word by word.

• Benign: This means "not serious." It means it is not cancer or a serious life-threatening condition.
• Paroxysmal: This means "coming on suddenly and then going away." This type of dizziness is not always present. It comes on suddenly and goes away in a few seconds or a minute.
• Positional: This means "related to position." This means that the dizziness only occurs when you suddenly change the position of your head.
• Vertigo: This is the medical term for "vertigo." It means that you feel as if the environment around you is spinning, even though you are standing still.

Simply put, BPPV is a sudden, but not serious, vertigo that goes away after a while when you change your head position. It's caused by a small problem in our inner ear.

Although this is not serious, the symptoms can be very scary. This dizziness can cause people over the age of 65 to lose their balance and fall . If you fall, it is important to be aware of this, as it can lead to fractures.

Who is more likely to experience this condition?

Although BPPV can affect people of any age, it is most common in people over the age of 50. In fact, it is estimated that about one in two people in this age group will experience BPPV at least once in their lives. It is very rare in children.

BPPV is diagnosed in about 20% of people who come to us for treatment for vertigo, or about one in five. It is such a common condition.

What are the symptoms of BPPV?

The main symptom is vertigo. However, there are several other symptoms that can accompany it. Let's look at these in the table below.

What causes this dizziness? (Triggers)

BPPV dizziness usually occurs when the head changes position. For example:

• While lying in bed.
• When you get out of bed.
• When you toss and turn in bed.
• When turning the head up (e.g. to pick something up from a shelf).
• When you bend your head down.

What really happens in the inner ear?

Okay, now let's look at why this happens. To understand this, we need to know a little about the structure of our inner ear.

Imagine that in your inner ear, where you control your balance, there are little sand-like things. These are actually calcium carbonate particles . In medicine, we call these otoconia . Normally, they are located where they should be, in an organ called the `utricle`.

But as we age, or when we have a minor head injury (such as a fall or accident), or when we have an infection, these 'balls' can become dislodged and move out of place. They then move into the semicircular canals, which contain fluid that is important for balance.

Now, when you shake your head, these particles also roll around in that fluid, stimulating the fine hair-like sensory parts (`cilia`) there. This sends the wrong signal to the brain. That signal is that 'you are spinning'. That's why we feel dizzy.

Sometimes BPPV symptoms can be caused by other ear conditions. For example, it can occur with conditions such as `(Labyrinthitis)` (an infection of the inner ear) or `(Vestibular neuritis)` (an inflammation of the nerve responsible for balance). People who have migraines are also more likely to develop BPPV.

Doctor, how will you diagnose and treat this?

If you have these symptoms, it's best to see your doctor. He or she will ask you about your symptoms and examine you.

There is a special test to diagnose BPPV. In this test, the doctor will have you sit on an examination table, turn your head to one side, and quickly lie you down. At this point, he will look at your eyes and check for dizziness or nystagmus (eye twitching). This will help him determine if you have BPPV.

The good news is that the treatment for BPPV is very simple. It does not require long-term medication. The main treatment is physical therapy exercises . These are called `canalith repositioning procedures.` These exercises work by moving the misplaced calcium crystals back to where they should be. Once there, they dissolve, so the vertigo does not return.

Simple exercises to reduce dizziness at home

One of these exercises is the Epley Maneuver. Your doctor will show you how to do this in the clinic and will also teach you how to do it at home.

Below is how someone with BPPV in the right ear does this exercise. (For the left ear, you should do it the opposite way.)

1. Step 1: Sit upright on a bed. Turn your head 45 degrees to the right (towards the affected side).

2. Step 2: Now, while turning your head to the right, quickly lie down on the bed . With your shoulders resting on the pillow, keep your head slightly off the bed. Stay in this position for 30-60 seconds, or until the dizziness stops completely.

3. Step 3: Without lifting your head, quickly turn your head to the left (90 degrees). Your left ear should now be facing the bed. Hold this position for 30-60 seconds.

4. Step 4: Now turn your entire body and head another 90 degrees to the left , tilting your head. Your nose should be facing the floor. Stay in this position for 30-60 seconds.

5. Step 5: Slowly sit up from the side you are leaning on, keeping your chin close to your shoulder.

This exercise will clear up 80%-90% of your symptoms after just one session. If you still have symptoms, you will need to repeat it as directed by your doctor.

When should you definitely see a doctor?

If you suspect you have symptoms of BPPV, be sure to see a doctor. That way, you can get an accurate diagnosis and learn the necessary exercises.

However, sometimes dizziness can be a symptom of a more serious condition.

These could be signs of a serious condition like stroke, so be very careful about these.