Benign paroxysmal positional vertigo is among the common causes of vertigo. It is the sudden sensation of the spinning of your head which occurs with the change of position of your head. It is a disorder of the inner ear. It occurs when calcium carbonate crystals accumulate in large numbers in any one of the ear canals and stimulate abnormal fluid movement in the inner ear. This sends false signals of head movement to the brain. This can also crop up post head injury. Rolling over the bed or quick head movements like when sitting up in bed can also trigger this condition. 

The common symptoms of benign paroxysmal positional vertigo are as follows: 

Vomiting and nausea. 
Vertigo Blurred vision
Intense dizziness 
Loss of balance 
Benign paroxysmal positional vertigo may be treated in the following manner: 

Medication to get relief from the spinning of your head. 
Epley's Maneuver involves transportation of the calcium particles to a different part of the ear which will no longer cause any problems. 
Brandt-Daroff exercises. 
Sometimes watchful waiting can help a person to recover without having to undergo any other treatment but it is a long process and often involves risk factors. 
Surgery: This option is used rarely when other treatments fail. 
A very important thing to remember is that vertigo can lead to falls and driving should be avoided. The patient will need support during an episode to avoid injuries.

All About Benign Paroxysmal Positional Vertigo

Dizziness, vertigo and balance issues are common symptoms and most of us may have experienced momentary symptoms. It is a sensation of feeling a movement even after the movement has stopped. For example the sensation we feel when we get off a merry-go-round or feeling butterflies in the stomach when we are on a roller coaster ride. Imagine if these symptoms are constant and start affecting our day to day activities. Even a simple task of walking can be bothersome as we may feel like our body is drifted and we cannot balance properly. We may feel a severe spinning sensation when we change position from lying down to sitting or rolling over in bed. It can also cause fear, anxiety and make us limit our movements and activities. These may cause more complications such as neck pain, headaches, body pains and depression. It is therefore very important to find out the root cause of vertigo and treat it immediately.

Dizziness is a sensation of light-headedness or unsteadiness. It can be caused heart disease, brain related causes like stroke, prolong illness, psychological issues, side effect of certain medications, blood pressure fluctuations and many other conditions. Neck stiffness, pain and weakness can also cause dizziness called Cervicogenic dizziness or Cervical Vertigo.
Vertigo is a spinning sensation or a feeling of motion when we are not moving. Its a common symptom in inner ear disorders. Some of the conditions that cause vertigo are: BPPV or Positional Vertigo, Meniere's, Labrynthitis, Vestibular Migraines, Vestibular neuritis, mal de barquement syndrome, perilymph fistula, toxicity of ears due to certain antibiotics, acoustic neuroma etc.
Balance problems or Disequilibrium means unsteadiness, imbalance or loss of equilibrium. It can occur as a primary symptom or with vertigo and dizziness.
You need to consult a Vestibular Therapist or Vertigo specialist who can diagnose your problem correctly. If you have Positional Vertigo known as BPPV then specific tests and manevers can help cure it completely. If there is inner ear disease such as Menieres disease, ear infections, labrynthitis or vestibular neuritis then proper medications prescribed by ENT specilialist and Vestibular Therapy can help you get rid of vertigo. In case the symptoms are related to Central nervous system (Brain) then promt treatment from Neurologist and Vestibular Therapist can help decrease vertigo and improve daily activities. If the symptoms are related to the neck called Cervical Vertigo or Cervicogenic Dizzienss then proper treatment of neck by a Vestibular Physiotherapist can help. Also making sure the posture is good when working on computer/laptops for prolong periods can prevent strain and reduce dizziness related to neck and back muscle tightness.

Vertigo & Dizziness - How You Can Get Rid Of It With Physiotherapy?

Vertigo refers to dizziness, or spells of dizziness, or rotational dizziness, which can be short term or long term. It is a general symptom for a variety of conditions of the brain, inner ear, sensory nerve pathway, and other sensitive organs. Vertigo has the capability of hampering the day to day functioning of the person. Furthermore, due to these reasons, it has the potential to cause anxiety and depression.

Types of Vertigo & Diagnosis:

Vertigo can be categorized into two major types based on the underlying cause:

1. Peripheral Vertigo: It is said to occur if it is related to the problems of the inner ear, such as its inflammation or an infection in its tiny parts or displacement of tiny particles present in the inner ears.

2. Central Vertigo: It is said to occur if it is related to the problems of the brain (the Central Nervous System) or the sensory nerve pathways.

Vertigo can be diagnosed by physical examination, assessing the medical history followed by undergoing a CT scan or an MRI, as required.

Treatment:

It is important to essentially understand the root cause of the condition and then treat that accordingly for best results.

1. A bacterial infection can be addressed through antibiotics.

2. Nausea and motion sickness can be reduced by using anti-emetics and antihistamines.

3. Sometimes, for patients with intractable Benign Paroxysmal Positional Vertigo (BPPV), surgery is performed to block the area triggering Vertigo.

4. Exercises can also help in managing the milder symptoms of Vertigo without visiting to the doctor for the same.

5. Most of the time, in case of BPPV, physiotherapy is the recommended treatment.

6. Certain lifestyle changes and precautions can be adopted to avoid conditions that trigger Vertigo.

7. Vestibular Rehabilitation Therapy goes a long way in managing Vertigo.

Vestibular Rehabilitation Therapy (VRT) for Managing Vertigo:

Vestibular Rehabilitation Therapy, abbreviated as VRT, is a program based on exercise that promotes the retraining of the Central Nervous System and repositioning of the free flowing particles in the fluid present in the inner ear. This helps in treating the condition of the inner ear for managing Vertigo. Its application is based on scientific research and evidence. The major goal of this type of treatment is to let the brain establish coordination again with the inner ear, with eye, and with the proprioceptive system for processing information.

The proprioceptive system consists of the sensory receptors which respond to pressure and stretch. Hence, VRT is effective in improving the diminishing quality of life due to Vestibular Disorders like Vertigo, by addressing both, the primary as well as secondary consequences of the condition. Over a period of time, when the patient becomes sufficiently trained under professional guidance, VRT can then be carried out at home at prescribed intervals based on the specific requirement.

Methods for VRT-

Depending on the clinical examination, the three major methods of exercise for Vestibular Rehabilitation Therapy can be prescribed, as described below:

1. Habituation exercises are prescribed for those patients who experience dizziness by movement and by visual stimulation.

2. Gaze Stabilization exercises are prescribed for those patients who experience uncontrolled eye movements leading to unclear vision.

3. Balance Training exercises are prescribed for improving steadfastness, to prevent falling, and to restore balance during performing activities like bending, standing and turning, reaching, walking, and running for helping patients return to their daily lives confidently.

Take Away:

Vertigo is the vestibular condition of dizziness that can be managed through methods like Vestibular Rehabilitation Therapy for re-training the brain to coordinate with the affected organs. It helps in restoring the quality of life. VRT is mainly practiced through habituation exercises, gaze stabilization exercises, and balance training exercises.

Managing Vertigo Through Physiotherapy And VRT!

Dizziness is now a very common problem among the adults. Maybe people do not take this to be a serious problem in many of the cases, but repeated feeling of dizziness may lead them to visit a doctor. When in the case of such situation, you visit a general physician, not knowing the causes of such problem; often the doctor will refer you to an ENT. There have been some reasons of why you should visit an ENT for dizziness.

Symptoms of Dizziness

Often dizziness occurs along with some other symptoms too. Some of the symptoms that are accompanied by dizziness are:

Anxiety
Nausea
Buzzing noise in the ears
Pressure in the ears and the head
Hearing issues
Some Important Reasons for Dizziness
If you are facing dizziness on regular grounds, then it may happen that it is due to some very serious health complications that you are suffering from. Some of the problems that may cause dizziness are:
Inner ear issues,

Issues in the central nervous system,
Issues related to the cardiovascular system,
Bacterial or viral infection,
Side effects of any medicine.
Diagnosis of The Problem
Diagnosis of the problem is the most important step in case of dizziness. It is because the diagnosis is not about whether you are feeling dizzy or not, it is the diagnosis about why you are feeling dizzy. There are some tests related to balance to diagnose the cause of dizziness. To get the tests done related to balance, you need to visit an ENT because the balance system of the human body is there located in the inner ear.
Though the balance of the body is there to the inner ear, also the test of other sensory organs such as eye and brain is also done. This is because balance disorder or dizziness happens when there is a problem in the communication system of the body. One of the most important ways to diagnose balance is by doing an eye test that is known as nystagmus.

Treatment of The Problem
After several tests of various sensory organs, when the ENT expert reaches a particular result, then the treatment starts depending upon the diagnosis. Today treatment for such balance disorder or dizziness has become common. Some problems can get solved by a changed diet only while other may need the help of medicines. Again, some of the problems may get cured by doing exercises while for some; you may need the help of a physiotherapist too.

When it is about dizziness, it is surely about balance disorder due to some major problems. Balance is controlled from with the inner eye and other sensory organs also, hence it is important to visit the ENT in this case.

Why Should You Consult An ENT For Dizziness?

Dizziness or vertigo is a feeling of being off centre, which makes a patient feel like there is lack of balance. This is especially apparent when one is at a height or while wearing footwear with high heels. It may be caused due to a variety of causes, and ear problems are one of the primary causes of this kind of dizziness. Let us take a look at the various ear problems and how they can cause dizziness or vertigo.


1. Infection: the bacteria or virus that causes cold and loose motions can also cause an ear infection. This can give rise to temporary vertigo which may last up to six weeks or more. Dizziness or vertigo happens in such cases because the viral effect spreads to the inner ear which causes a ringing and off balance sensation. The general physician or ent specialist will usually prescribe a round of medicines only if the condition becomes too severe to handle.


2. Benign paroxysmal positional vertigo: this kind of dizziness is also known as bppv and may be caused due to the motion of a calcium particle known as otolith, in the ear. This can cause a fluttering movement that gives the sensation of falling down or losing balance. This usually takes place in the part of the ear that catches the sensation of gravity. The movement of the otolith can make the patient feel as if his or her head is turning or swaying, while in reality the patient may be stationery. This problem can be fixed with the help of a two minute therapy known as epley manoeuvre, which can be conducted easily in the ent specialist's clinic.


3. Meniere's disease: there is actually a specific condition that is characterised primarily by dizzy spells and vertigo. The other symptoms of this ear bone condition include ringing of the ears, loss of hearing, and the feeling of fullness or pressure build up in the ears. This can be fixed with therapy and drugs as well as hearing loss aids.


4. Dandy's syndrome: this is an ear condition where the patient constantly feels like he or she is bouncing up and down. This condition hits patients who are on antibiotic medication for any kind of infection, and it subsides once the medication is done with. It occurs in such cases because certain kinds of antibiotics may be toxic for the ear. One may also see natural improvement in the condition over the passage of time.


5. Tumours: other reasons like tumours and strokes can also cause vertigo on a temporary or permanent basis.


Dizziness due to ear problems can be due to a number of mild to severe reasons. It is best to get these causes checked.

How Ear Problems Can Cause Dizziness

Acoustic neuromas are tumors that develop on the nerves connecting the ear to the brain. Being non-cancerous in nature, they do not spread to other parts of the body. However, they are characterized by symptoms such as gradual or sudden hearing loss, more pronounced with either of the ears, a ringing sensation in the affected ear, weakness, facial numbness and dizziness.

Causes:

Acoustic neuroma can be of two types: one is sporadic in nature and the other is associated with a condition known as neurofibromatosis type II (NF2). NF2 is basically an inherited disorder identified by benign growth in the nervous system. NF2 being a rare disorder, makes the sporadic type the dominant one. Although the causes behind this type of neuroma are still unknown, long term exposure to radiations, especially around the neck and the head, could be one of the most important triggering factors.

Treatments:

Once the diagnosis is done, treatments for acoustic neuroma depend on the growth and size of the tumor.

Diagnosis with the help of monitoring: Small tumors exhibiting no such symptom or slow signs of growth need to be monitored with the use of hearing tests and regular imaging. In case, the MRI scans are able to trace any sort of development on the part of the tumor or if the tumor poses subsequent difficulties, opting for treatment becomes the need of the hour.

Stereotactic Radiosurgery: Also known as Gamma Knife, radiosurgery is a treatment method wherein controlled radiations are used to treat tumors, thus doing away with the need of making any incision.

Surgical Removal: Surgery performed under general anesthesia is directed towards removing the tumor; that helps to preserve the facial nerve and thus inhibit facial paralysis and hearing loss. The tumor is usually removed either through the ear or through the skull.  

Experiencing Dizziness? It Could Be A Sign Of Acoustic Neuroma

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