Benign Positional Paroxysmal Vertigo (BPPV)
BPPV is thought to be caused by tiny crystals becoming dislodged from the walls of your balance (semicircular) canals in your inner ear. These can be loosened by: age, head injury, infection, and other disorders of the inner ear. These crystals then roll around in the fluid of your inner ear and cause the sensation of movement (vertigo).
BPPV is diagnosed based on symptoms, physical tests and sometimes hearing or balance tests. Other tests such as CT’s or MRI’s are sometimes required for more unusual cases. It can be possible to have BPPV in both ears. This can make diagnosis and treatment more challenging.
BPPV is “self-limiting” as the crystals causing the symptoms will dissolve within 6 months. However, physical manoeuvres to move the crystals away from where they are causing problems can resolve the vertigo in 80-90% of cases, in just 1-2 treatments.
The Epley manoeuvre is the most commonly used and involves moving your head in a sequence to allow gravity to move the crystals. Your therapist will perform the technique during your session and may also give you instructions to perform the technique at home.
It is important to understand that you will get your symptoms while doing the technique. This is okay, it means the crystals are being moved around.
Alternatively, your therapist may recommend that you perform the Brandt-Daroff technique. This also involves a sequence of movements aimed at moving the crystals to a less sensitive area of your inner ear.
Both of these techniques will usually resolve any lasting symptoms in about 7 days if performed correctly. However, 1 in 3 patients will get BPPV again in 1 year and 1 in 2 will have a recurrence by 5 years. If this occurs, the manoeuvres can be repeated for the same benefit.
Additionally, you may be given techniques to improve your balance and decrease your sensitivity to certain head and eye movements.