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The doctor said that I have crystals in my ears.” Demystifying BPPV

by | Jul 22, 2022 | Balance & Vestibular Disorders | 0 comments

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What is benign paroxysmal positional vertigo (BPPV)?

Vertigo is the feeling that of room spinning or the world is spinning around you and has many causes.  Benign paroxysmal positional vertigo is a very common cause of vertigo that causes brief vertigo spells that come and go.  Vertigo will last for as little as a few seconds but can last for a few minutes in some cases.  The feeling of dizziness after experiencing vertigo can last for a few moments but can be as long as several hours. 

What causes BPPV?

BPPV is caused by a problem in the inner ear. We all have tiny calcium carbonate “crystals” inside our inner ears help keep us balanced.  When one has BPPV, these stones are allowed to shift errantly into the semicircular canals in the inner ear where they can cause a feeling of spinning / vertigo.

What are the symptoms of BPPV?

The primary symptom of BPPV is a feeling that one is spinning or tilting their head when they are not.  It can happen when we move head in a certain way, like rolling over in bed.  One may find it hard to walk or stand without losing your balance.

How is BPPV diagnosed?

BPPV is diagnosed with a physical examination. Your doctor will ask questions about your symptoms and past health. You may have you perform is series of tests including the Dix-Hallpike test and Roll test. During these tests, your doctor watches your eyes and monitors for vertigo / dizziness while turning your head in specific ways.

How is BPPV treated?

Vertigo due to BPPV is treated by performing a series of maneuvers where the head is placed in different positions to move the displaced crystals of the inner ear back to where they are supposed to be.  Your physical therapist will often need to assist you with these maneuvers however some patients can be taught to perform the necessary maneuvers on their own.  Without treatment 20% of those effected with BPPV will experience a resolution of their complaint within 1 month and up to 50% are better in 3 months.  Physical therapy can reduce this timeline down to a matter of days to resolve the condition. 

Can my vertigo come back? 

If a patient has experienced a single bout of vertigo / dizziness due to BPPV there is a 10 to 20% reoccurrence rate.  If one has experienced several previous bouts of BPPV then the reoccurrence rate is much higher. 


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