How do you fix benign paroxysmal positional vertigo?

Benign Paroxysmal Positional Vertigo, or BPPV, as it is commonly known, is one of the most common causes of vertigo in adults. It is characterized by sudden spinning sensations, where the patient feels as if the world around them is spinning or moving even if they are perfectly still. Patients often feel disoriented, off-balance, nauseous, & also experience symptoms of motion sickness when suffering from BPPV.  BPPV affects about 80% of all Vertigo patients, & is also quite easy to treat once diagnosed properly.

BPPV Causes:

benign paroxysmal positional vertigo causes range across a variety of medical conditions. Usually, BPPV is caused by inner ear infections & problems that make it difficult for the vestibular system to send & receive balance-related signals from the brain.  The body’s vestibular system is made up of the eyes, the ears, & the brain. These three have to work in absolute harmony for the body to be properly balanced at any given time.  When the patient experiences an inner ear infection, it can give rise to BPPV symptoms.

The various inner ear conditions that can cause BPPV to include:

The displacement of calcium crystals: The primary cause of BPPV is tiny calcium crystals in the middle ear getting accidentally dislodged in the semicircular canal of the inner ear, & causing problems with the detection of proper balance signals by the brain. These calcium crystals, also called canaliths, are sensitive to motion, & help the brain detect the body’s position in space according to various motion stimulants. When they get dislodged from their original position & get deposited inside the semicircular canal, they cause confusion between the body’s actual position & the motion stimulants perceived by the brain due to the misplaced crystals. This confusion is what causes dizziness, nausea, & motion sickness in BPPV patients.

How it is treated:

BPPV treatment for BPPV caused by misplaced calcium crystals in the inner ear include

• Canalith Repositioning Maneuvers: Canalith repositioning maneuvers are exercises designed to help replace the misplaced calcium crystals inside the semicircular canal. These exercises include the well-known Epley Maneuver, the Brandt-Daroff maneuver, the Semont-maneuver, & other assorted exercises. These exercises can either be performed at home by yourself or under the supervision of a doctor or a licensed practitioner. They consist of easy maneuvers designed to help facilitate the movement of calcium crystals from the semicircular canal to their original location.

1. Brandt-Daroff Exercises

Brandt-Daroff exercises utilize gravity to help dislodge crystals from the semicircular canal so that they no longer pose a problem in maintaining the body’s balance.

This exercise can be performed at home in a few simple steps as given below:

• Sit in the bed with your feet on the floor, then turn your head 45 degrees in the right direction.
• Without changing the direction of your head, lie down on your left side on the bed. Maintain this position for about 30 seconds.
• Slowly return to the starting position, & take a 30-second pause.
• Now, turn your head 45 degrees on the left side, & repeat the previous steps in the right direction.
• Return to the starting position & pause for 30 seconds.
• Repeat this set of procedures about five times in a single sitting.

2. Epley Maneuver

The Epley Maneuver is another popular & commonly recommended exercise for Vertigo. Most patients with Vertigo get relief from their symptoms with the Epley Maneuver. Although the original Epley Maneuver can only be performed with the help of at least two other people, the modified Epley Maneuver can be easily performed by yourself at home.

Below is the procedure for performing the Epley Maneuver at home if you have left-ear BPPV. In the case of right ear benign paroxysmal positional vertigo, just perform the steps in the opposite direction.

• Sit on the bed in an upright position, while placing your legs straight ahead in front of you with a pillow behind you.
• Next, turn your head 45 degrees to the left.
• Lie on your back quickly until your shoulders are on the bed. Hold this position for 30 seconds.
• Next, turn your head 90 degrees to the left without lifting it up. Hold this position for 30 seconds.
• Now, turn your body & head another 90 degrees to the right & hold for 30 seconds.
• Next, sit upright on the right edge of the bed.

3. Semont Maneuver

The Semont Maneuver, also known as the liberatory manoeuvre, is another exercise for Vertigo recommended for BPPV treatment. It takes less time to perform than the Brandt-Daroff exercise; however, these should best be done in the presence of a healthcare provider.

For the below set of exercises, we’ll assume that you have left-ear BPPV.

• Sit on the edge of your bed in an upright position & turn your head 45 degrees to the right.
• Quickly drop to your left until your head is on the bed, & hold this position for 30 seconds.
• Next, quickly move your body to the right side in a single movement without changing the position of your head.
• Hold this position for 30 seconds, then slowly return to the starting position

Surgical Alternatives:

In some cases, where no other BPPV treatment options seem to be working for the patient, your doctor may recommend the canal plugging surgery to you. This surgery involves using a bone plug to block the portion of the inner ear that is causing the problems. This surgery is often the last resort for patients for whom no other benign paroxysmal positional vertigo treatment options seem to be working. The success rate for canal plugging surgery is about 90%, & it is a safe, long-lasting alternative for desperate situations of BPPV.