Vertigo – the sensation of motion in which the person or the person’s surroundings seem to spin and move – is, typically an unpleasant experience. Feelings of vertigo can disrupt balance and lead to falls which can be critical in the elderly; vertigo might also be combined with dizziness, sensations of spinning in space, and more rarely, vomiting, nausea, migraine headaches, visual irregularities including nystagmus, and fainting.
There are various distinct forms of vertigo with varied root causes. Audiologists generally run into benign paroxysmal positional vertigo, abbreviated BPPV, since it is related to your sense of hearing. BPPV occurs as the result of calcium crystals that form naturally called otoconia or otoliths, which in most people cause no problems. In people who suffer from benign paroxysmal positional vertigo, however, these crystals become dislodged from their normal location and migrate into one of the semicircular canals of the inner ear which control our sense of balance. When this happens, and the person with benign paroxysmal positional vertigo reorients their head relative to gravity, these crystals move around, resulting in an abnormal displacement of endolymph fluid, which results in vertigo.
BPPV can be triggered by such common actions as tilting or turning your head, looking up and down, and rolling over in bed, and is characterized by the episodic (paroxysmal) nature of the attacks. These symptoms can be worsened by sleep disorders, stress, or changes in barometric pressure, such as occur before rain or snow. The condition can manifest itself at any age, but it most commonly appears in individuals over age 60. The initial trigger for the BPPV is generally hard to pinpoint. An unexpected blow to the head (such as in an automobile accident) is among the more well-known causes.
BPPV is different from other varieties of vertigo or dizziness because the attacks are quite short (generally under a minute), and because it is always brought on by movements of the head. Health professionals usually diagnose benign paroxysmal positional vertigo by having their patient lie on their back on an examination table, rotating their head to one side or over the edge of the table to see whether this triggers an episode. There are many rigorous tests which can be used to diagnose BPPV, such as electronystagmography (ENG) or videonystagmography (VNG), which test for abnormal eye movement, or magnetic resonance imaging (MRI), which is used primarily to rule out other potential causes of the vertigo.
BPPV is typically treated using a technique called canalith repositioning which shifts the crystals to a position in the inner ear where there are less problematic using a sequence of physical motions. Two types of canalith repositioning that may be used are the Epley maneuver and the Semont maneuver. In about 10 percent of cases, surgical treatment may be suggested if these treatments don’t provide satisfactory outcomes. If you’ve experienced unexplained dizziness or vertigo that lasts for over a week, see your doctor.
