Benign Paroxysmal Positional Vertigo (BPPV)- Dizziness with position changes

I had a patient come in the other day with a new onset of dizziness when getting out of bed.  He told me that he experiences dizziness when he moves his head in certain directions and that he has been avoiding those movements…….FOR THREE YEARS!  He also had a sense of imbalance and sway when he was walking.  After a thorough vestibular examination, he was found to have BPPV, or Benign Paroxysmal Positional Vertigo.

It is important to know that dizziness and vertigo (sense of spinning) are not diseases or diagnoses; they are SYMPTOMS of an underlying problem, often a problem in the inner ear.  Calcium carbonate crystals (otoconia) are a normal part of our inner ear.  They help detect body and head movement and help with balance.  In BPPV, these crystals become dislodged which causes dizziness or vertigo when you change positions (rolling in bed, bending over, looking up).  The onset of the dizziness can be caused by trauma or hitting the head, but most often occurs unprovoked.  It is suspected that with age, the crystals can become more brittle and break loose.

There is a very effective treatment for BPPV which involves the physical therapist taking the patient through a series of positions to realign the crystals. Here is a useful video demonstrating how the crystals are moved through the canal during a positioning maneuver.  Often, patients only need one or two treatments and their dizziness is resolved.  Our certified vestibular specialist uses infrared goggles to monitor eye movements in different head and body positions to allow for a more accurate diagnosis of which ear and canal is affected. 

The patient I alluded to only needed one re-positioning maneuver.  By the next day he was back to moving his head in directions he hasn’t moved in years without dizziness.  You don’t have to live your life avoiding activities because they make you dizzy.  Schedule a vestibular therapy appointment today.

Rachel Long PT, DPT
Vestibular Specialist

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