Balance problems, Dizziness, Vertigo:
You might have BPPV (Benign Paroxysmal Positional Vertigo), but
Benign paroxysmal positioning vertigo (BPPV) is a disorder caused by inner ear problems. The most common symptoms are repeated episodes of positional vertigo, or of a spinning sensation caused by changes in the position of the head.
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BPPV Symptoms - Do I have BPPV ?
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Always consult a physician before pursuing any treatment.
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What is BPPV?
BPPV is the most common cause of vertigo related to the ear. About 1 in 5 people
who have dizziness will have BPPV. This number increases in the elderly or in at
risk populations. About every 1 in 40 people will have BPPV at some point in their life.
While BPPV is common, it is not the cause of all types of dizziness. It is usually possible to differentiate BPPV from other causes. If the following statements describe your dizziness, it is likely that you suffer from BPPV:
- My dizziness lasts only seconds (less than one minute, never hours or days).
- The symptoms occur with certain head positions
(e.g. looking up, bending down, turned sideways whilst lying down)
- It feels like either the room or my body is spinning.
- My dizziness is not associated with a change in my hearing or a noise in my ears.
Information to help diagnose BPPV
(modified from M von Brevern, A Radtke, F Lezius, M Feldmann, T Ziese, T Lempert: Epidemiology of benign paroxysmal positional vertigo. A population-based study in Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:710-715)
- "Vestibular Vertigo" is dizziness related to the ear (you must have at
least one of following 3 symptoms):
- Spontaneous rotational vertigo (sudden spinning of self or the surrounding)
- Positional vertigo (Spinning when changing the head position)
- Recurrent dizziness with nausea (sick to the stomach) and
either nystagmus (involuntary eyemovements making it difficult to read) or imbalance.
- Benign paroxysmal positional vertigo (ALL 4 of the following must be true):
- Recurrent "Vestibular Vertigo" (as above)
- The duration of the attack must always be < 1 minute
- Symptoms invariably provoked by the following changes of head position:
- Lying down or
- Turning over in the supine (lying on your back) position
or at least 2 of the following manoeuvres:
- Reclining the head
- Rising up from supine (lying on your back) position
- Bending forward
- Not attributable to another disorder
The gold standard to diagnose are the history and the typical nystagmus (eyemovement) seen during the Hallpike manouvre. A video of the Hallpike manouvre can be seen here.
If the above tests show that you have BPPV, then the DizzyFIX may be right for you!
People with BPPV experience rapid involuntary eye motion called Nystagmus when changing head position in relation to space. The Nystagmus associated with BPPV is rotatory (13 MB movie link). The top of the eye moves towards the ground. This is called Geotropic. The Nystagmus disappears after several seconds and the associated vertigo passes.
A diagnostic worksheet for BPPV produced by Dr Umapathy:
Just click here: BAAP document for BPPV
If a violent sudden vertigo/dizziness is associated with double vision, other problems seeing or swallowing or moving limbs poor circulation of the brain can be the reason. This can be a warning sign or part of a stroke and immediate medical care is required. This is NOT BPPV.
A stroke requires urgent hospital care!
If in doubt always act on the side of caution and see medical help straight away.