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Benign Paroxysmal Positional Vertigo (BPPV) in Toronto
Benign paroxysmal positional vertigo (BPPV) refers to episodes of sudden and severe dizziness associated with head movement. Vertigo & dizziness symptoms commonly can be triggered by rolling over in bed, getting out of bed, and lifting head to look up.
A person affected by vertigo symptoms may have attacks of vertigo for a few weeks, then a period of time with no dizziness symptoms at all. The symptoms can come and go with no apparent reason.
BPPV is caused when the particles within the vestibular system are misplaced and it usually affects only one ear, however occasionally it can occur in both ears at the same time.
What are the Symptoms of BPPV?
The symptoms of BPPV can include:
- Sudden episodes of violent vertigo
- Dizziness and/or nausea
- Movements of your head trigger the vertigo
- Your vertigo may last half a minute or more
- Your eyes may drift and flick uncontrollably (nystagmus)
What Causes BPPV?
Inside the inner ear there are three semicircular canals filled with fluid. These canals are oriented at different angles. With each head movement, the fluids inside these channels are moved creating signals to inform the brain stem of the direction, speed and quality of movement.
The muscles between the diaphragm and the pelvic floor constitute your core. A strong lumbar spine and pelvis supports your whole body. In fact, most movement involves the core, so it is an essential part of our orthopaedic and physiotherapy treatments.
BPPV is caused by little calcium carbonate crystals or otoconia within the vestibular canals. Occasionally conservative BPPV treatments such as physiotherapy and medication fail. If despite treatments, the symptoms continue for more than 12 months, an operation may be needed.
Who Performs BPPV Treatment?
BPPV can only be treated by physiotherapists or other healthcare practitioners who have undertaken specific training to diagnose and successfully treat. Our Vestibular trained physiotherapist is registered with the College of Physiotherapists of Ontario. Vestibular physiotherapy is covered by most insurance plans.
These crystals are held in special reservoirs within other structures of the inner ear (saccule and utricle). These crystals can be dislodge and displaced due to injury or degeneration of the utricle and move into the balance organ and interfere with your vestibular system. The vestibular physiotherapy is to relocate these crystals to their original location.
The following factors cause or allow crystals to migrate into vestibular canals include:
- Head or ear injury such as concussion.
- Ear surgery or ear infection, such as otitis media
- Degeneration of the inner ear structures
- Vestibular neuritis (viral infection of the inner ear).
- Meniere’s disease
- Some types of minor strokes
- Idiopathic (no cause can be found)
How is BPPV Diagnosed?
Not every dizzy patient is suffering from vestibular condition. A wide range of medical conditions can cause dizziness and vertigo. Therefore, it is important to find the exact cause of these symptoms. Vestibular physiotherapy is effective in managing dizziness and vertigo when the cause is in vestibular system. The rehabilitation protocols can help patients manage the balance disorders related to the vestibular system involvement.
What is the Treatment for BPPV?
otolithe Relocation Techniques
After the assessment and the confirmation of BPPV diagnosis, our Vestibular trained physiotherapist will apply specific techniques to relocate the displace otolithic debries to an area in the inner ear that doesn't stimulate the feelings of dizziness or vertigo.
Is BPPV treatment successful?
When BPPV treatment techniques are performed correctly, reduction of the vertigo, dizziness and other symptoms of BPPV is immediate in 80% or more of cases. In most cases (90%+), quality BPPV practitioners have high success rate within three applications of the manoeuvres.
In addition, doctors may prescribe some medication to diminish your sensitivity and mask BPPV symptoms.