Vertigo – a perception of motion where the individual or the individual’s surroundings appear to whirl dizzily – is, typically an unpleasant event. Vertigo feelings can disrupt your balance and lead to falls which can be dangerous among older adults; it can also be accompanied by sensations of spinning in space, dizziness, and more rarely, vomiting, nausea, migraine headaches, visual abnormalities such as nystagmus, and fainting spells.

There can be many root causes for vertigo, but one form of it – benign paroxysmal positional vertigo, or BPPV – is related to hearing. Benign paroxysmal positional vertigo is due to calcium crystals that form naturally in the inner ear known as otoliths or otoconia, and which typically cause no issues. In people who suffer from benign paroxysmal positional vertigo, however, these crystals become dislodged from their normal location and travel into one of the semicircular canals of the inner ear which govern our sense of balance. When an individual with BPPV reorients their head relative to gravity, these crystals displace endolymph fluid and induce vertigo.

BPPV can be brought on by such basic movements as turning or tilting your head, looking up and down, and rolling over in bed, and is characterized by the brief (paroxysmal) nature of the episodes. The resulting vertigo can be worsened by stress, lack of sleep, or changes in barometric pressure (for instance, just before a rainfall or snowfall). Although BPPV can start at any age, it’s more common in people over 60 years old. It is hard to establish the specific cause of BPPV for any given patient, however it generally develops following accidents in which the individual receives a blow to the head.

BPPV is readily distinguished from other varieties of vertigo because it is nearly always triggered by movements of the head with symptoms subsiding in one minute or less. Doctors may diagnose it by having the patient lie on their back and then tilt their head to one side or over the edge of the examination table. Other tests that can be used to diagnose BPPV include videonystagmography or electronystagmography, which test for abnormal eye movement, and magnetic resonance imaging (MRI), whose primary role is to eliminate other possible causes, such as brain tumors or brain abnormalities.

The standard treatment for BPPV is canalith repositioning, such as the Semont maneuver and the Epley maneuver, both of which are a series of physical motions used to shift the crystals to a position in the inner ear in which they no longer cause trouble. Surgical treatment is an option in the rare cases in which these treatments are not effective. If you have experienced unexplained vertigo or dizziness that lasts for over a week, see your health care provider.

The site information is for educational and informational purposes only and does not constitute medical advice. To receive personalized advice or treatment, schedule an appointment.
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