Benign Paroxysmal Positional Vertigo (BPPV)
What is it?
Benign paroxysmal positional vertigo (BPPV) is dizziness that arises abruptly upon changing the position of the head (for instance, while tilting the head to look upward, sitting up, or, most often, turning over in bed). Symptoms generally last less than a minute, but they can be extremely disconcerting and may be accompanied by loss of balance, nausea, and vomiting. Such episodes may recur several times a day. Contrary to popular belief, recurrent or chronic dizziness indicates a brain tumor less than 1 percent of the time.
What Causes It?
- Balance is maintained by otoliths, tiny calcium stones that press on hairlike fibers deep in the canals of the inner ear. When bent, these fibers send signals to the brain so it can calculate the head's position. As people age, minuscule amounts of debris may slough off and press on these fibers. This interferes with the sense of balance by sending false signals to the brain,resulting in BPPV.
- A prior head injury or viral infection of the inner ear may contribute to BPPV development.
Prevention
- Until you receive successful treatment, try to avoid the positions that induce dizziness.
- Avoid sudden, rapid head movements.
Diagnosis
- Your doctor may order various tests to determine the exact cause of vertigo and to rule out a more serious underlying disorder.
How to Treat It
- Lie down until symptoms go away.
- Certain medications—such as antihistamines (which can have an antinausea effect) and scopolamine (a motion-sickness drug)—may be prescribed to ease dizziness.
- In one treatment technique, a doctor will induce dizziness by moving the patient's head rapidly or slowly to one side, holding the position for a few minutes, then repeat the procedure for the opposite side. Afterward, the patient sits up and must keep the head upright for 48 hours (even while sleeping). A cervical collar helps to maintain the correct head position. This treatment produces complete remission in 60 percent of BPPV cases and improvement in another 30 percent.
- The patient is instructed to move his or her head in a way that induces dizziness. He or she then performs this technique several times a day for a few weeks. This treatment has been shown to be effective in the vast majority of patients.
When to Call a Doctor
- Make an appointment with your doctor if you experience episodes of severe dizziness.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.