Benign Paroxysmal Positional Vertigo (BPPV)

Have you ever experienced a sudden sensation of spinning or dizziness when you roll over in bed or stand up suddenly? If so, you might have encountered a condition known as Benign Paroxysmal Positional Vertigo (BPPV).

What is BPPV and what are some of its symptoms?
BPPV is a common vestibular disorder impacting the inner ear, eliciting symptoms which include dizziness, unsteadiness, and feelings of nausea. It is commonly seen in people over the age of 65, however can affect people of any age. BPPV can be triggered when a person’s head or body is placed in a certain position. A common trigger is rolling over in bed or when going from lying down to standing. Symptoms are often experienced in intense recurrent bursts typically lasting between 20 – 60 seconds. Episodes of BPPV may resolve within a few weeks or months and at times may even reappear years later.

A breakdown of what BPPV means:

          Benign – meaning it is not a threat to your life.

          Paroxysmal – meaning the dizziness comes in short recurrent bursts.

          Positional – meaning the dizziness is provoked by certain body or head positions and or movements.

          Vertigo – the medical name assigned to the spinning sensation.

Whilst BPPV is not life-threatening it can have a significant impact on a person’s quality of life.

What causes BPPV?
BPPV occurs when crystals within the inner ear become dislodged disrupting our vestibular (or balance) system. As your head moves, the dislodged crystals also move causing incorrect messages to be sent to the brain and subsequently the eyes. This leads to the feelings of dizziness even after relatively small movements of the head. BPPV can be caused by; (i) head injuries, (ii) degeneration of the vestibular system associated with ageing and, (iii) damage caused by an inner ear disorder.  

Treatment options for BPPV

Brandt-Daroff Exercises
The Brandt-Daroff exercises are a series of movements one can perform to help manage certain types of vertigo such as BPPV. These exercises are designed to help through providing relief by dislodging and breaking up the crystals which form within the inner ear. The Brandt Daroff exercises have been shown to be a relatively safe exercise for individuals to try alone however they can elicit symptoms of vertigo and it is therefore recommended you have someone nearby when performing for the first time. Despite these movements possibly eliciting symptoms of vertigo it is important to persist with them for a prolonged time to determine whether or not it is effective for you.

How to perform the Brandt Daroff exercises:

1.       Start seated on the edge of a couch or bed.

2.       Turn your head 45 degrees to your left and lie down onto your left side simultaneously. Perform this part of the movement within 1-2 seconds.

3.       Once you are lying down with your head angled 45 degrees remain in this position for approximately 30 seconds.

4.       After 30 seconds slowly return back to a seated position and remain upright with your head facing forward.

5.       Repeat on the other side.

Lifestyle recommendation
If you experience BPPV you may consider;

          Being mindful of movements that may elicit symptoms.

          Use good lighting if you need to get up during the night.

          Sit or lie down upon dizzy spells.

          Continue with exercise and challenge your balance within a safe environment.

          Use a mobility aid if required to reduce the risk of falls.


Additional Treatment
Should your symptoms of BPPV continue for a prolonged time or become debilitating, consider booking in with a physiotherapist, audiologist, or other specialist who will be able to conduct specific maneuverers or supply additional exercises to help manage your vertigo. It can be important to seek help during early stages of symptoms to mitigate the risk of falls or injury. In extreme cases, surgery may be performed however non-invasive measures such as exercises and maneuverers should be conducted as a first line of defence. 

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