What is BPPV and how do we treat it?

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

What causes BPPV?

Inside the inner ear is a series of canals filled with fluid. These canals are oriented at different angles. When the head is moved, the rolling of the fluid inside these canals tells the brain exactly how far, how fast and in what direction the head is moving.

BPPV is thought to be caused by little calcium carbonate crystals (otoconia) coming loose within the canals. Usually, these crystals are held in special reservoirs within other structures of the inner ear (saccule and utricle). It is thought that injury or degeneration of the utricle may allow the ‘crystals’ to escape into the balance organ and interfere with the fluid flow.

How is BPPV diagnosed?

A physio will ask questions about your symptoms, so take note of when it occurs, duration and movements that trigger it.

During an assessment, the physio will likely use a test where they watch the patients eyes while turning the patients head. Positional testing will also be used and in some cases a CT or MRI may be required.

Home Remedies

There are some things you can do at home to reduce the symptoms of BPPV:

  • Avoid sleeping with the affected ear down
  • Drink plenty of fluids to avoid dehydration and additional dizziness.
  • Avoid movements that trigger an episode of dizziness
  • Perform home exercises prescribed  by the physio

How do we treat BPPV?

The Epley Manoeuvre is a form of physio in which head manoeuvres are used to try to help with removing the calcium crystals from the posterior semicircular canal. A physio will assist with these slow, simple manoeuvres, which are usually quite effective. Each head position is held for approximately thirty seconds. The manoeuvre usually offers relief after just a few sessions.