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

Vertigo is a medical condition where the affected person feels that the world or surrounding environment is spinning or moving. It is accompanied with nausea, vomiting, sweating and having problems in walking steadily. Moving your head worsens this condition. An illusion of movement is observed.

Vertigo arises from several conditions. There are mainly two types of Vertigo-

Peripheral Vertigo: This is the most common vertigo and is caused often due to a problem in the balance mechanism of the inner ear. The causes include:

Benign Paroxysmal Positional Vertigo: Being one of the common causes of vertigo, BPPV occurs due to certain head movements when standing up or bending over. The attacks are short, powerful and recurrent in nature. Nausea is also accompanied. A feeling of lightheadedness and despaired balance is observed after the attack. Fragments of calcium carbonate crystals are broken off from the channel linings present in the inner ear. These fragments cause the problem by getting into the ear fluid canals, and certain head movement sweeps them across the canal causing vertigo.

Head Injury: Vertigo develops due to head injuries, and the symptoms are similar to that of dizziness.
Labyrinthitis: It is an infection in the inner ear, which causes the labyrinth of the ear to get inflamed. The labyrinth controls our hearing and balance. An inflammation causes it to send different information than the other, normal ear. This conflict causes vertigo. Such vertigo can be accompanied by nausea, vomiting, loss of hearing and ear pain.

Vestibular Neuronitis: This is a condition pertaining to the inner ear, which causes inflammation of the nerve which connects the labyrinth to the brain. The condition arises from viral infections. Nausea and vomiting are observed, and this condition leads to vertigo.

Meniere's Disease: This rare condition in the inner ear causes severe vertigo along with hearing loss and aural fullness. Meniere's disease prompts sudden vertigo attacks with nausea and vomiting.
Central Vertigo: Central vertigo arises from problems in the cerebellum of the brain and brainstem. Causes include:

Migraines.
Sclerosis, a condition which affects the central nervous system.
Acoustic neuroma, a type of brain cancer growing on the acoustic nerve.
Brain tumors, stroke or transient ischemic attack.
Certain medications.
Treatment-
Treatment of vertigo depends on the cause and on the extent of symptoms. Labyrinthis and vestibular neuronitis are cured by vestibular rehabilitation and medication. BBVV is treated using a process called the Epley maneuver. Meniere's disease is cured by modes of dietary restriction, medication, treating tinnitus and treating hearing loss. Generally, curing the cause of vertigo helps in healing the disorder.

Vertigo is caused by different reasons and factors and rectification of these factors helps in the treatment of vertigo.

Vertigo: Causes and Treatment

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

Are you feeling lightheaded, unbalanced or woozy lately? Are you having strange sensations in the ears and eyes? These indicate that you are suffering from dizziness, a condition affecting the body s sensory organs. It can cause fainting at times as well. It is not a disease, but a symptom of several disorders. Dizziness is caused by inner ear disturbances, effects of medication, motion sickness and underlying health conditions, such as poor blood circulation, infections or injuries.

Test and diagnosis
If you feel dizzy for a prolonged period of time or if the dizziness occurs and reoccurs, a special treatment is required. This is because dizziness may make you prone to several risks in everyday life. Several tests are carried out to find out the cause of the dizziness. If a stroke is suspected, an MRI scan or CT scan is carried out. A physical examination is undertaken in which the way you walk and balance are observed and the nerves of the central nervous system are checked. Hearing and balance tests may also be required, which are as follows:

Eye movement testing in which the path of the eyes is observed while tracking an object in motion. An eye motion test may be given where cold and warm water is placed in the ear canal.
Head movement tests are carried out when benign paroxysmal positional vertigo is suspected.
Treatment
Treatment of dizziness includes medicines, therapies and balance exercises.

Medicines

Water pills are prescribed when a patient has Meniere s disease, which helps in reducing dizziness.
Antihistamines provide temporary relief from dizziness.
Therapy

Head position maneuvers: A technique known as canalith repositioning helps in resolving dizziness quickly. It can be performed by a doctor, therapist or audiologist. The position of the head is maneuvered in the process.
Balance therapy: Several exercises help in making the body s balance system lesser sensitive to motion. This technique, known as vestibular rehabilitation, is used for people suffering from dizziness due to inner ear conditions.
Psychotherapy: This therapy may be used for patients who experience dizziness because of anxiety disorders.
Use of antibiotics: An antibiotic by the name of gentamicin may be injected in the inner ear for disabling the balance function. The unaffected ear performs that function.
Other procedures: A procedure known as labyrinthectomy may be used for disabling the vestibular labyrinth in the affected ear.
If you experience dizziness continuously, it is important for you to visit an ENT specialist. An ENT specialist deals with problems related to the ear, nose and throat and will be able to provide you with the best diagnosis and treatment for dizziness.

Dizziness - Can it be a Sign of Ear Disturbance?

BPPV or Benign paroxysmal positional vertigo is a major cause of vertigo. This is a condition that gives a sensation of head spin all of a sudden. It also results in dizziness in brief episodes. The severity level can vary from intense to mild. BPPV is triggered with certain changes of the head position. Although BPPV is bothersome, it isn t serious unless there is a chance of a person falling abruptly because of the head spin. There are ample treatment options available to address this problem.

Symptoms of BPPV
BPPV includes some of the following symptoms:
a. Loss of balance
b. Dizziness
c. Feeling of the surrounding spinning
d. Vomiting and nausea
e. Rhythmic movement of the eye

When to seek medical attention?
If dizziness is accompanied with one of the below-mentioned symptoms, it is time to urgently seek medical attention and get vertigo addressed for good:

Hear loss
Tingling or numbness
Fever accompanies with severe headache
Arm or leg weakness
Problems with vision
Difficulty in walking
Becoming unconscious
Causes of BPPV:
If there is on known cause associated with BPPV, the condition is termed as idiopathic BPPV. In most of the cases, though, BPPV is associated with a severe to minor blow to the head. Other causes include an injury to the inner ear, prolonged sitting position in a fixed posture, even migraine pain is at times associated with BPPV.

What are the risk factors?
Benign paroxysmal positional vertigo is likely to occur in the age group of 50 and above, this being said it can happen at any age in case of any injuries. Statistically, it is found that the likelihood of BPPV is more in women than men. Head injury of any sort is by far the most likely reason of BPPV.

What are the tests and diagnosis involved?
A doctor is likely to perform a physical examination followed by a series of tests. Some typical signs that a doctor looks for include the following:
Ability to control eye movement- especially side to side movement

Symptoms of dizziness
In case it is difficult to spot the symptoms, a doctor might suggest video- nystagmography or electronystagmography. It helps to track irregular eye movement. An MRI can also be prescribed to study the cross-sectional images of the body and the head.

Treatments associated with BPPV:
BPPV mostly go away within months or weeks on its own. If however, it still persists, a doctor can suggest Canalith Repositioning- series of small movements that helps to counter BPPV. For extreme cases, a doctor might advise a surgery for blocking the portion of the inner ear that might be causing the problem. It guarantees close to a 100 percent fix to BPPV.

Vertigo / Dizziness - When To Seek Medical Attention?

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!

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