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The #1 Cause of Dizziness | Benign Paroxysmal Positional Vertigo (BPPV) - Diagnosis & Treatment

By: Dr Cliff Olson
November 25, 2019
Video Transcript

You know that feeling you get when you get off of a merry-go-round and you feel like you are still spinning?  Well that is what it is like to have Benign Paroxysmal Positional Vertigo. BPPV causes dizziness following head movements or body position movements.  Basically, if you have ever become dizzy by just rolling out of bed, you may have had BPPV at some point.  

BPPV is the most common cause of dizziness.  Let's explore the description of BPPV.  Benign means that it won't kill you.  Paroxysmal means that the episodes are of brief duration.  Positional means that it is triggered by movement, and Vertigo is the sensation of movement, such as spinning, when there is no head movement.  

BPPV occurs when crystals called otoconia, normally embedded in the utricle become dislodged and migrate out to one of the three fluid filled semicircular canals. These crystals DO NOT belong in the semicircular canals. As head positions change, cause additional stimulation of the sensory hair cells in the semicircular canals which sends false information to the brain which leads to the sensation of dizziness.   BPPV is the most common cause of vertigo with 50% of individuals over the age of 70 experiencing this type of dizziness.  

Symptoms of BPPV may come and go, and you may feel symptom free for a period of time, as long as you refrain from significant head movement.  It is important to know that hearing loss is not a symptom of BPPV.  If you have hearing loss along with dizziness, this could indicate a serious medical condition and you should see your physician immediately.

Diagnosis of BPPV requires structured positional movements along with the evaluation of nystagmus which are involuntary eye movements.  If a nystagmus is seen and the appropriate semicircular canal is identified, then treatment can be administered.  According to Dr. Richard Gans of the American Institute of Balance (https://www.Dizzy.com) treatments called Canalith Repositioning can be used to guide the dislodged crystals back into the Utricle.  These repositioning techniques are extremely effective, but should only be done under the supervision and assistance of an individual specifically trained in the diagnosis and treatment of dizzy conditions.  

Attempting to diagnose and treat BPPV yourself can be dangerous considering that if you perform treatment incorrectly, you could make your condition worse.  The good news is, diagnosis and treatment of BPPV is relatively straight forward when treated by a specially trained Physician or Audiologist.  Just make sure to follow your Doctors post treatment instructions.  

So the next time you experience intense, brief spells of dizziness, when you change head or body position, make sure you contact your Audiologist or Physician to get your condition diagnosed as soon as possible.

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