Is my dizziness BPPV
For anyone who has experienced severe dizziness they can attest as to how horrible and disconcerting this can be. One of the most common causes of dizziness (especially in people over 50) is benign paroxysmal positional vertigo (BPPV). Is your dizziness BPPV?
Benign Positional Paroxysmal Vertigo (BPPV)
BPPV is a condition that is characterized by brief episodes of dizziness, nausea or nystagmus (uncontrollable eye shaking) triggered by head movement. Some people may notice symptoms when lying down or sitting up in bed. Others might notice symptoms when they tilt their head back or to the side.
The inner ear is made up of a series of canals filled with fluid. As we move our head the fluid brushes over nerve hair cells that send messages to the brain with information about exactly how far, how fast and in what direction the head is moving. The brain combines this with information it also receives from the eyes and sensory nerves in the muscles and joints of the body (especially the neck) so it has an accurate image of where the body is in space.
BPPV is thought to be caused by little calcium carbonate crystals (otoconia) coming loose within the canals. These crystals are normally held in special reservoirs within other structures of the inner ear (utricle). Injury or degeneration to the utricle may allow the crystals to escape into the canals. Once inside the canals, the crystals stimulate nerve hairs, so the brain thinks the body is moving, even when it is not. This mis-match creates vertigo.
A practitioner is required to make an accurate diagnosis of your dizziness. However, the name BPPV itself, gives significant clues to help with the diagnosis.
Although the symptoms can be severe, BPPV is benign. In the words of Arnold Schwartzenegger, “It’s not a tumour!” In some cases certainty of diagnosis will only come from extensive testing that may include a brain MRI. But in most cases BPPV presents with classic signs and symptoms, so an experienced clinician can usually make a diagnosis from history and simple clinical tests.
If a specific canal is affected, then your dizziness will be brought on by specific head positions and movements. Turning your head to the right might be fine, but to the left might bring on dizziness.
Symptoms may be intermittent and fluctuate. They may stop for several weeks, then return for shorter or longer periods.
Vertigo is a sensation that you are spinning or the world spinning. True vertigo is the feeling you experience with BPPV. This is not the same as general dizziness. If you experience light-headedness, floating, unsteadiness or general imbalance and not spinning, it’s possible you don’t have BPPV.
Can my neck cause dizziness?
Yes. Cervicogenic dizziness is the term that describes dizziness caused by neck problems. If you have this type of dizziness, then you won’t feel the ‘spinning’ that is typical of BPPV, but you may experience neck discomfort. The ‘Neck Torsion Test’, can help differentiate between a neck cause or an inner ear cause of dizziness. This test involves twisting the neck but keeping the head still. If this produces dizziness, then your problem is with the neck. To see this test in action, check out this video.
Highly successful treatment
Is your dizziness BPPV? If so, an Epley’s Manoeuvre has been shown to be successful in improving BPPV in 80-95% of cases. The success rate is higher when repeated and when combined with neuro-rehab home exercises. The Epley’s Manoeuvre is similar to the child’s toy where you try to move a ball bearing though a maze with a series of movements. To see an Epley’s in action, check out this video.
If you’d like discuss your dizziness with one of our practitioners, you can call the practice or book online.