As strange as it seems, everyone has microscopic crystals residing in their inner ears. These crystals are called Otoconia and are found in the Otolith organs, which are two pouches inside the vestibular system that are filled with fluid. The pouches are lined with small hairs and the small hairs are lined with the Otoconia. When the head tilts, the crystals attached to the hairs move through the ear fluid and send nerve signals to the brain.
Benign Paroxysmal Positional Vertigo, or BPPV, is a condition that occurs when your Otoconia break loose and roll into the semicircular canals of the inner ear. This is usually caused by a hard hit to the head or ear. Normally, your ear canals sense rotational tipping movements of the head when the fluid inside of them moves. When crystals are knocked loose into the canals and head rotation occurs; the crystals move more slowly than the fluid, causing an imbalance in the ear signals. This in turn leads to BPPV, which is characterized by sudden bouts of vertigo (dizziness) brought on by quick head movements.
Fortunately, BPPV is easily treatable and will usually only require 1-2 therapy sessions. Since there can be many different reasons for vertigo and loss of balance, proper diagnosis by an ENT physician is crucial. If your doctor suspects BPPV, they will run a diagnostic test called the Dix-Hallpike test to evaluate your symptoms. Other tests may be required to achieve a complete diagnosis. Using the test, your doctor will check for involuntary eye movements while you are in a position that triggers your vertigo.
Once your physician verifies that BPPV is the cause of your vertigo, they will perform procedural maneuvers to move the crystals out of the canal and back into their place of origin. After the maneuver is performed, the crystals will dissolve and symptoms will be alleviated. You may have to undergo these repositioning procedures several times, with brief breaks in between, to completely eliminate BPPV. The success of the treatment is over 80% with the first procedure. The recurrence rate is approximately 30%, however there is a higher chance of recurrence if you are an older adult. If BPPV still occurs frequently after your visit, your therapist may teach you an at home treatment that can temporarily relieve symptoms.
Contact us if you have any further questions or would like to schedule an appointment.