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Benign Paroxysmal Positional Vertigo (BPPV)

People who experience Benign Paroxysmal Positional Vertigo (BPPV) may have brief yet intense episodes of vertigo, but the good news is that this condition is generally easy to treat. Read on as we share more information about BPPV treatment, including how physiotherapy can assist. What is BPPV? Benign Paroxysmal Positional Vertigo (BPPV) is an inner ear problem that results in short-lasting, but often severe vertigo (spinning/ dizziness) and nystagmus (rapid eye movement). These symptoms are triggered by changes in head position such as looking down or looking up, or rolling over in bed. To understand more about why this happens we’re going to briefly discuss the vestibular system in your inner ear.

The Vestibular System and Balance Your vestibular system – deep within your inner ear – consists of semicircular canals. The canals contain fluid and some small crystals (otoconia) attached to sensitive hair-like structures. When your head moves, the fluid makes the crystals and hairs move, and then a signal is sent to your brain to say that you are moving your head. This information on your head position allows the brain to respond and send signals to the muscles of your limbs, torso, and eyes. In this way the vestibular system is involved in the control of balance and coordination of head and eye movements. Thus, allowing us to sit, stand and walk without fear of falling, no matter what position our head is in.

BPPV Causes It is believed that people experience BPPV when the crystals (discussed above) within the semicircular canals become dislodged and move around the inner ear. Causes of the condition are thought to include:

  • A head injury/ knock to the head

  • An inner ear disorder

  • Ageing and the degeneration of the vestibular system

Anyone can experience BPPV, however, we often see patients present with the condition who are middle-aged and elderly. People who have it once are not necessarily susceptible to getting it again.

Is BPPV Serious? BPPV is severe but not serious and can last from weeks to months. Sometimes the condition will resolve on its own, but in most cases you will need the treatment to resolve the problem. In saying that, it is a condition that is typically easy to treat with physio and home exercises. More about treatment and exercises below.

How is BPPV Diagnosed? BPPV can be diagnosed by a physiotherapist who is trained to perform the Dix Hallpike manoeuvre or the Supine head turn test. These tests will show which canal in the inner ear is affected and this will in turn guide your treatment.

BPPV Treatment BPPV is treated with a similar manoeuvre to the test performed by a physiotherapist. The direction and position of the manoeuvre will depend on which canal is affected. Your physio will perform 2-3 repetitions of this manoeuvre for a few sessions until the symptoms are very mild. Once you have reached this point you will be able to perform the manoeuvre yourself at home. If there is more than one dislodged crystal, you may require multiple treatment sessions. While most physiotherapists can treat the common forms of BPPV, there are rare instances where patients are referred to a specialist vestibular physiotherapist. Physiotherapy for BPPV in Darwin Do you have any further questions about treating or diagnosing BPPV? Our qualified team in Darwin are here to help.

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