BPPV - Caidr
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BPPV

Updated 04.04.2022
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BPPV stands for benign paroxysmal positional vertigo – quite a mouthful, but it literally means dizziness when changing position, and without any sinister underlying cause. The inner ear is a series of tubes that give us our sense of balance, as well as hearing, and in BPPV, tiny crystals collect in the tubes, disrupting this. It’s the most common cause of vertigo, the sensation of the room spinning around you. This gives brief episodes of dizziness lasting less than a minute, and usually triggered by certain head movements. BPPV can also cause a loss of balance and nausea or vomiting. BPPV is more common the older you get, and in most cases occurs as a result of age-related degeneration of the ear system. There is no cure for BPPV, but it’s not usually a sign of anything serious, and will get better on its own after several weeks.

What causes BPPV?

BPPV has no identifiable cause for the majority. If you’ve had to hold a position for a prolonged period of time, such as reclining for a dental procedure or prolonged bed rest, this could have prompted BPPV. Other cases occur if there’s damage or disruption to the inner ear, causing crystals to build up, such as a head injury – from mild concussion or whiplash to recovering from severe head injury – or surgery to the inner ear.

How can I manage my symptoms at home?

BPPV can resolve on its own after a few weeks without any treatment. In the beginning, try to avoid movements of your head in certain directions that might bring on dizziness. Later on, you will need to suffer a little of this discomfort and move your head to allow the crystals to disperse – try this only in a safe space. Even though this brings on symptoms, this will aid recovery. Avoid causing yourself any injuries from falls by walking in good lighting and taking things slow and easy; hang on to a rail or solid furniture if necessary. Do not drive and be aware of the signs of dizziness. Sitting down immediately will help alleviate the sensation.

When should I see my doctor?

If your dizziness is not resolved after several weeks, it is causing significant symptoms that affect your day-to-day activities or you get severe or prolonged episodes, you should see your doctor. They will examine your eyes and head movements, especially those that bring on symptoms, and they may examine your nervous system. If there are any concerns, your doctor may refer you to a specialist for further investigations, such as an MRI to see if there is another more serious cause for your symptoms. If there are no concerns, your doctor may perform some simple exercises known collectively as the Epley manoeuvre to improve your symptoms. They may give you exercises to do at home called Brandt-Daroff exercises. A physiotherapist should also be able to help with this. Your doctor may offer medication such as motion sickness tablets, but it only helps ease symptoms, it can't speed up time to recover.

When should I seek help urgently?

If your dizziness is accompanied by any of the following, you should seek urgent medical attention, as there could be a more serious cause for your symptoms: a new or different type of headache, fever, blurred or double vision, loss of vision, sudden hearing loss in one ear, and weakness or numbness and tingling in the arms and legs.

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