BPPV

Inside the inner ear

BPPV stands for benign paroxysmal positional vertigo and that's what I had recently.

It can be quite quite scary if you don't know what it is. We had just changed rooms to sleep and all four of us (husband and the two boys) started sleeping together in the same room. I woke up one morning and on trying to get up had the sudden sensation that the inside of my head was spinning (or otherwise know as vertigo). There was a period of fairly intense dizziness too.

Other symptoms can include a loss of balance or unsteadiness, nausea and even vomiting which I did not have.

BPPV is usually triggered by specific changes in the position of the head. And it can occur when you move your head up or down, rolling over in bed, or when you turn over or get in and out of bed in a certain way.

How is this so you must be wondering? Well, inside our ears is a tiny organ called the vestibular labyrinth. It has three semi circular canals that contains fluid and fine hair like structures that gives you information about that position of your head.

Otolith organs inside your ear monitor up, down, left, right etc movements of your head. They also contain calcium carbonate crystals (or otoconia) that make you sensitive to gravity.

These otoconia can become dislodged and when they happen to move into one of the semi circular canals when you are lying down. When too much otoconia accumulates in one of the canals, it causes the semi circular canal to become sensitive to changes to the position of our head, sending false signals to the brain. And this is what makes you dizzy or your head to feel like it is spinning.

When the dislodged otoconia moves into a semi circular canal, the eyes can move in a specific to and fro manner called nystagmus. I didn't have any nystagmus on testing but if you do that can be scary.

Other than being scary if you don't know what's happening, BPPV can increase the chance of you falling.

Medication will not help BPPV although in some cases it does resolve on its own after a while.

BPPV can sometimes be misdiagnosed by general practitioners who are not familiar with the testing or treatment of BPPV. The impact can be mildly annoying to highly debilitating and can affect function, safety and risk of falling.

How did I get better? Well, fortunately Gino knew how to treat BPPV using the Epley Manoeuvre. He treated me once and I was much better after that.


Reference

Fife TD et al (2008). Practice Parameter : Therapies For Benign Paroxysmal Positional Vertigo (An Evidence-based Review) : Report On The Quality Standards Subcommittee Of The American Academy Of Neurology. Neurology. 70: 2067-2074.