Benign Paroxysmal Positional Vertigo (BPPV)
Benign paroxysmal positional vertigo (BPPV) is an inner ear problem that causes short periods of dizziness when your head is moved in certain positions. It is one of the most common types of vertigo, a spinning sensation in your head that can be very disturbing. It occurs most commonly when lying down, turning over in bed, or looking up.
BPPV occurs when pieces of calcium carbonate material (often called “ear rocks”) break off from a part of your inner ear (the utricle) and move to another part of the inner ear. When you move your head a certain way, the crystals move inside the canal and stimulate the nerve endings, causing you to become dizzy. The crystals may become loose due to trauma to the head, infection, conditions such as Meniere disease, or aging, but in some cases there is no obvious cause.
HOW CAN A PHYSICAL THERAPIST HELP?
After a confirmed diagnosis following a series of tests, most people recover from BPPV with a simple but very specific head and neck maneuver performed by a physical therapist. The maneuver is designed to move ear crystals from the semicircular canal back to into the appropriate area of the inner ear (the utricle).
The most common treatment is called the Epley maneuver. The physical therapist shows you how to move your head through a series of 4 positions, with the head staying in each position for about 30 to 60 seconds. In the Semont maneuver, the body is rapidly moved from lying on one side to lying
on the other.
Depending on information from your test results, you might be asked to perform Brandt-Daroff exercises, which need to be performed several times per day for several days; however, these exercises have not yet been shown to be effective in clinical trials.
In a very few cases, BPPV cannot be managed with treatment maneuvers, and a surgical procedure called a “posterior canal plugging” may be considered—but that’s usually a last resort, and rarely ever done.
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