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Vestibular Physiotherapy
If you've been suffering with or have been diagnosed with BPPV (Benign Paroxysmal Positional Vertigo) - we can help!
What is BPPV?
Benign Paroxysmal Positional Vertigo (BPPV) is a common, but potentially debilitating vestibular disorder which involves sudden and intense episodes of vertigo (a sense of spinning or dizziness), that are triggered by changes in head position.
BPPV occurs when tiny calcium carbonate crystals, (called otoconia) become dislodged from their usual position in the inner ear. These crystals, which normally help with balance by responding to gravity, end up floating into one or more of the semicircular canals of the inner ear.
This misplacement interferes with the ear’s ability to send accurate balance information to the brain, causing the sensation of spinning or dizziness.
Symptoms of BPPV
- Sudden Vertigo: Intense spinning or dizziness that occurs with specific head movements, such as rolling over in bed or looking up.
- Nausea: Feeling sick to the stomach due to the vertigo.
- Nystagmus: Involuntary eye movements that often accompany the vertigo.
Common Triggers
- Head Movements: Quick or specific movements, such as tilting the head back or turning over in bed, can trigger symptoms.
- Changing Positions: Symptoms often arise when changing from lying down to sitting up, or from sitting to standing.
Diagnosis
BPPV is typically diagnosed through a physical examination that includes specific tests like the Dix-Hallpike maneuver, which helps to identify the presence of nystagmus and reproduce the symptoms.
It’s important to run through a variety of tests & take a full subjective history to ensure that any red flags or other causes of symptoms are not missed, and appropriate onward referrals can be made if required.
Treatment
The main treatments for BPPV are:
- Repositioning Maneuvers: Techniques like the Epley maneuver or Semont maneuver are used to move the displaced crystals back to their correct position in the inner ear.
- Vestibular Rehabilitation Therapy (VRT): Includes exercises and strategies to improve balance and reduce symptoms. This can include Brandt-Daroff Exercises, Gaze stabilisation exercises, and balance & coordination training.
Prognosis
BPPV is considered benign, meaning it's not life-threatening and often resolves with treatment.
However, the symptoms can be quite distressing and impact daily activities, making timely management important.
If you think you may have BPPV, or are experiencing symptoms, our physios are well equipped to assess and treat you, or organise referral onto specialist services if required.