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Advanced Alternative Medicine Center

Advanced Alternative Medicine Center

Benign Positional Vertigo

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In this video, Dr. Huntoon discusses if having symptoms is ever normal and what you should know if you have symptoms.

Benign Positional Vertigo is a pretty severe symptom to have and should be looked at by someone who understands the inner workings of the ear and the various causes associated with the condition.

Click on any of the links to the right or scroll down for more information.

Benign Positional Vertigo   

Vertigo - positional; Benign paroxysmal positional vertigo; BPPV

Benign positional vertigo is a condition in which a person develops a sudden sensation of spinning, usually when moving the head. It is the most common cause of vertigo.

Causes, incidence, and risk factors

Benign positional vertigo is due to a disturbance within the inner ear. The inner ear has fluid-filled tubes called semicircular canals. The canals are very sensitive to movement of the fluid, which occurs as you change position. The fluid movement allows your brain to interpret your body's position and maintain your balance.

Benign positional vertigo develops when a small piece of bone-like calcium breaks free and floats within the tube of the inner ear. This sends the brain confusing messages about your body's position.

There are no major risk factors. However, the condition may partly run in families. A prior head injury (even a slight bump to the head) or an inner ear infection called labyrinthitis may make some people more likely to develop the condition.

Symptoms

People with this condition feel as though they are spinning or moving, or that the world is spinning around them. They may experience:

Nausea, vomiting, hearing loss, and a loss of balance

Vision problems, such as a feeling that things are jumping or moving

The spinning sensation:

Is usually triggered by moving the head

Often starts suddenly

Lasts a few seconds to minutes

Most often, patients say the spinning feeling is triggered when they roll over in bed or tilt their head up to look at something.

Signs and tests

To diagnose benign positional vertigo, the health care provider will often perform a test called the Dix-Hallpike maneuver.

The health care provider holds your head in a certain position and asks you to lie quickly backward over a table.

As you do this, the health care provider will look for abnormal eye movements and ask if you feel a spinning sensation. The doctor may use different

methods to help evaluate your eye movements.

A physical exam should otherwise be normal. A complete medical history and careful brain and nervous system (neurological) exam should be done to rule out other reasons for your symptoms.

Tests that may be done include:

EEG

Electronystagmography (ENG)

Head CT

Head MRI

Hearing test

Magnetic resonance angiography of the head

Warming and cooling the inner ear with water (caloric stimulation) or air to test eye movements

Treatment

The Alternative Perspective

The most effective treatment is a procedure called "Epley's maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. Other exercises that can readjust your response to head movements are less effective.

The Medical Perspective

Occasionally, medications may be prescribed to relieve the spinning sensations. Such drugs may include:

Antihistamines

Anticholinergics

Sedative-hypnotics

However, these medicines often do not work very well for treating vertigo.

To prevent your symptoms from getting worse during episodes of vertigo, avoid the positions that trigger it.

Expectations (prognosis)

Benign positional vertigo is uncomfortable, but usually improves with time. This condition may occur again without warning.

Complications

Patients with severe vertigo may get dehydrated due to frequent vomiting.

Calling your health care provider

Call your health care provider if:

You develop vertigo

Treatment for vertigo has not worked

You develop symptoms such as weakness, slurred speech, or vision problems that may be signs of a more serious condition

Medicines Two Choices for You

Your Solution

The most effective treatment is a procedure called "Epley's Maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. Other exercises that can readjust your response to head movements are less effective.  Finding a practitioner (Medical ENT or Alternative practitioner) who knows how to do the Epley's Maneuver would be important.  Calling and discussing the specifics before the office visit is the least that can be expected.

Prevention

Avoid head positions that trigger positional vertigo.

References

  1. Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 165.
  2. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82:361-369.

 

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