Benign Paroxysmal Positional Vertigo (BPPV) is a common problem affecting approximately 10% of the population. This condition causes dizziness, vertigo, and balance problems and can significantly impact a patient’s quality of life. Below, we will examine the importance of BPPV, its symptoms, diagnosis, and treatment options in more detail.
What is Benign Paroxysmal Positional Vertigo (BPPV)?
BPPV is a peripheral type of dizziness caused by the movement of particles, called otoliths (or calcium carbonate debris), located in the semicircular canals of the inner ear, disrupting the circulation of endolymph. Otoliths move with changes in head position, but in cases of vertigo, movement continues even after the head has stopped moving. This creates a “false sense of movement,” which manifests as brief episodes of dizziness, typically lasting less than one minute.
Symptoms and Risk Factors
Symptoms characteristic of BPPV include brief episodes of dizziness triggered by changes in head position. These symptoms often occur when getting out of bed, tilting the head upwards, or making certain movements. Additionally, nausea and vomiting may occur, but ringing in the ears or hearing loss is not usually present. Previous head trauma or vestibular disorders increase the risk of BPPV. Additionally, a connection has been observed between osteoporosis, lower levels of vitamin D, and the occurrence of BPPV. There is also a correlation between BPPV and sleeping position, with patients preferring to sleep on their predisposed side.
Diagnosis and Treatment
Diagnosing BPPV involves taking a thorough patient history and conducting an examination, including assessing the nose, ears, and throat, cardiovascular system, and evaluating neurological status. In cases of clinical suspicion, specific tests such as the Dix-Hallpike and Roll tests can confirm the diagnosis. The Dix-Hallpike maneuver, used for posterior semicircular canal debris, should be performed on all patients suspected of BPPV. The goal of treatment is to reposition the calcium carbonate debris into their correct position. This is achieved using the Epley maneuver, performed in the direction where the problem occurs. It is important to explain the possible side effects of the maneuver, such as nausea and vomiting, to the patient, and to monitor the effectiveness of the treatment.
