Benign Paroxysmal Positonal Vertigo (BPPV)

Ongoing dizziness is not an uncommon problem and diagnosis can be elusive. Statistically 50% of people of over 65 years of age who complain of dizziness have BPPV (benign paroxysmal positional vertigo), making it quite common. Statistics also show that most people will visit several doctors before the condition is correctly diagnosed, and hence it is one of the more overlooked medical conditions.

People with BPPV often complain of brief episodes of vertigo (feeling the room is spinning) when changing positions. Typical triggering factors include rolling in bed or looking up/down. The attacks themselves can be quite debilitating, as I have treated many patients who reported of being initially admitted to hospital on suspicion of a stroke. The dizziness associated with BPPV can settle after a few days, but some people are left with ongoing dizziness with sudden movements. It may cause fatigue, nausea and results in unsteadiness or poor balance in over 50% of sufferers.

The condition is caused by the tipping of calcium carbonate crystals into the semi-circular canals located within the inner ear. The inner ear is a structure approximately the size of your thumbnail which is responsible for sensing and relaying information concerning your balance to your brain. The crystals disturb the movement of fluid within the inner ear, which alters its sensation of your balance. This is what causes the sensation of dizziness.

The best news is that treatment is often simple, and the Epley’s manoeuvre is the treatment of choice. This is a series of movements performed gently to tip the crystals back into their normal position. Studies show that it is successful in 80% of patients after just 1 treatment.

Other causes of dizziness include unilateral vestibular dysfunction, neck-related dizziness, Meniere’s Disease and other medical causes (e.g. low blood pressure or drug-induced). Studies also show that vestibular rehabilitation and balance exercises are effective in treating unilateral vestibular dysfunction, which is a dysfunction of the nerves on one side of the inner ear.

Although dizziness is difficult to diagnose and is often overlooked, simple and effective treatment is available.