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Vertigo - (BPPV) Benign Paroxysmal Positional Vertigo

Definition

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning. Benign paroxysmal positional vertigo is characterized by brief episodes of mild to intense dizziness.

Symptoms of benign paroxysmal positional vertigo are triggered by specific changes in the position of your head, such as tipping your head up or down, and by lying down, turning over or sitting up in bed. You may also feel out of balance when standing or walking.

Symptoms

The signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include:

  • Dizziness
  • A sense that you or your surroundings are spinning or moving (vertigo)
  • Lightheadedness
  • Unsteadiness
  • A loss of balance
  • Blurred vision associated with the sensation of vertigo
  • Nausea
  • Vomiting

The signs and symptoms of BPPV can come and go, with symptoms commonly lasting less than one minute. Episodes of benign paroxysmal positional vertigo and other forms of vertigo can disappear for some time and then recur.

Activities that bring about the signs and symptoms of BPPV can vary from person to person, but are almost always brought on by a change in the position of your head. Abnormal rhythmic eye movements (nystagmus) usually accompany the symptoms of benign paroxysmal positional vertigo. Although rare, it's possible to have BPPV in both ears (bilateral BPPV).

When to see a doctor

Generally, see your doctor if you experience any unexplained dizziness or vertigo that recurs periodically for more than one week.

When to seek emergency care

Although it's uncommon for dizziness to signal a serious illness, see your doctor immediately if you experience dizziness or vertigo along with any of the following:

  • A new, different or severe headache
  • A fever of 101 F (38 C) or higher
  • Double vision or loss of vision
  • Hearing loss
  • Trouble speaking
  • Leg or arm weakness
  • Loss of consciousness
  • Falling or difficulty walking
  • Numbness or tingling
  • Chest pain, or rapid or slow heart rate

The signs and symptoms listed above may signal a more serious problem, such as stroke or a cardiac condition.

Causes

  • BPPV is often associated with a minor to severe blow to your head.
  • Damage your inner ear.
  • Prolonged positioning on your back or stomach.
  • BPPV also has been associated with migraines and TMJ.
  • Cervical Disc problems.
  • Dislodged otoliths(tiny crystals found in the semicircular canals that make you sensitive to gravity).
  • When they become dislodged, they can move into one of the semicircular canals — especially while you're lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy.

Risk factors

Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. Aside from aging, there are no definite factors that may increase your risk of benign paroxysmal positional vertigo. However, a head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Complications Protocol for Vertigo

Although benign paroxysmal positional vertigo (BPPV) is uncomfortable, it rarely causes complications. In rare cases, if severe, persistent BPPV causes you to vomit frequently, you may be at risk of dehydration. The dizziness of BPPV can put you at greater risk of falling.

Preparing for your appointment

Here's some information to help you get ready for your appointment.

What you can do

  • Write down your symptoms, including when they started and how often they occur.
  • Note any recent blows to your head, including even minor accidents or injuries.
  • Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins and supplements you're taking.
  • Take a family member or friend along, if possible. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor. Creating your list of questions can help you make the most of your time with your doctor.

Questions to ask the doctor at the initial appointment include

  • What are the possible causes of my symptoms or condition?
  • What tests do you recommend?
  • If these tests don't pinpoint the cause of my symptoms, what additional tests might I need?
  • Do I need to follow any restrictions while we're seeking a diagnosis?
  • Should I see a specialist?

What to expect from your doctor

We may ask a number of questions, such as:

  • What are your symptoms, and when did you first notice them?
  • Do your symptoms come and go? How often?
  • How long do your symptoms last?
  • Is one or both of your ears affected?
  • Does anything in particular seem to trigger your symptoms, such as certain types of movement or activity?
  • Do your symptoms include vision problems?
  • Do your symptoms include nausea or vomiting?
  • Do your symptoms include headache?
  • Have you lost any hearing?
  • Have you had any weakness, numbness or tingling in your arms or your legs?
  • Have you had any difficulty talking or walking?
  • Have you had chest pain?
  • Are you being treated for any other medical conditions?
  • What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

Dr. Berry's Laser Protocol for Vertigo

The Class IV K-Laser is at the heart of our treatment program. It provides a safe, effective, non-invasive, painless solution for vertigo. Patients respond exceptionally well to treatments and usually notice significant pain relief after just a few treatments. Dr. Berry’s program utilizes the latest FDA Cleared Lasers, and combines them with other therapies to help reduce the pain, strengthen the muscles and increase range of motion. Most importantly these treatments help reduce inflammation/swelling, which helps improve overall function. Dr. Berry has been treating sports injuries for over 35 years and has been helping people suffering from various health conditions during that time. Patients seek his advice and care if they want to avoid surgery if at all possible and help you return to all the activities you enjoy.

Listen to this patient tell her story!