You have been diagnosed with benign paroxysmal positional vertigo (BPPV). Vertigo causes a false sense of motion or spinning. With BPPV, small crystals from the utricle of the inner ear collect in the semi-circular canals of the inner ear. There are three semi-circular canals of the inner ear. Where the crystals have collected determine your treatment.
Symptoms of BPPV are usually noted as a short, 10-15 second, sense of vertigo while lying back in bed, rolling over, coming to a sit position in bed, bending forward or looking up. Some patients also report nausea or problems with balance lasting longer than 10-15 seconds. The symptoms of BPPV are often intermittent. The symptoms may be present for a period of time, seem to resolve on their own, and then return. Numerous problems of the vestibular system can be present with these same symptoms. That is why it is important you seek medical attention to determine the cause of your dizziness.
A medical professional will speak to you about your history of symptoms. An examination of your eye movements with your head in a variety of positions will then be performed. One position of testing is known as the Hallpike position. This involves you moving from a sitting to lying position with your head turned to the side while observing your eye movements. You may also be asked to lie down with your head in other positions to assess the other semi-circular canals. Testing is painless, but may provoke your symptoms.
Treatment is specific to the semi-circular canal involved. Once the affected semi-circular canal is determined, a specific "canalith repositioning maneuver" is performed. The result of these repositioning maneuvers remove the crystals from the semi-circular canals and return them to the utricle of the inner ear. Treatment takes less than 10 minutes. The Epley maneuver is used to treat posterior semi-circular canal problems. This maneuver places you on your back into the position that cuases your symptoms, your head is then moved in a specific series to reposition the crystals. If your problem is found to be in the horizontal semi-circular canals, the Lempert roll will be required. This involves lying on your back and turning the head and body slowly 270 degrees. Both of these treatment procedures are painless, but they can reproduce your symptoms.
Treatment with these techniques is 90 percent effective for patients with BPPV. If your vertigo does not resolve after one visit, additional treatments may be necessary. You will be instructed to avoid leaning over or bending your neck for 48 hours after the treatment.