Vertigo Cures

Benign Positional Vertigo

It happened to me about 10 years ago. I lowered my head down to sleep after a normal day and WHAM!! I had the most violent and disturbing bout of dizziness I have ever had. My eyes rolled uncontrollably as the room spun around and around with a dizziness intense enough to make me vomit. Following this initial episode I continued to have bouts of dizziness whenever I would lie on my right side or move my head suddenly.

If this experience sounds familiar then you probably have a condition called Benign Positional Vertigo (BPV). It’s a condition that I see quite regularly in my practice. While it is usually distressing for those afflicted it is not serious and is quite easy to treat.

BPV is distinguished mainly by two points.

1. The dizziness associated with BPV is always related to movement of the head or change in body position.

2. BPV dizziness has a fatiguing quality to it. The dizziness is most intense immediately after movement and then fades away.

The inner ear contains structures that give us a sense of position in relation to gravity. These structures are the semicircular canals. There are three canals for each ear positioned perpendicular to one another. This gives us three dimensions of position sense. The canals are filled with fluid and are lined with sensitive hair cells that detect movements of particles suspended within the fluid. The movement is picked up by the hair cells as the particles flow past them. In this way movements of the head are detected and we become aware direction within space even when our eyes are closed.

It is theorized that the intense dizziness of BPV is caused when the particles stick together and form clumps. The clumps act like boulders within the semicircular canals and over stimulate the hair cells as they move past them. No one knows for certain what triggers the clump formation but it often correlates to recent colds or allergic reactions.

Epley’s maneuver is the treatment I recommend to my patients because it is simple to perform and usually clears the dizziness in a matter of days without the need for medication.

The first thing one must do is assess which ear affected. Usually the severe dizziness and eye rolling have a repeating rotational quality. I tell my patients to pay attention to which direction the room seems to spin when the dizziness comes. If it seems to spin to the right, then the right ear is the problem. Conversely, if the spinning is to the left, then it’s assumed the left ear is the one with the clumps. Once the problem side is detected a few simple movements done in the correct order is all that is required.

EPLEY’S MANEUVER

The steps outlined below will be for someone with right ear dizziness.

Step one. (Head Extension-Right Rotation) Lie down on your back and let your head hang off the edge of the bed so that it is tilted back with the head turned to the right so that the right ear is pointing to the floor.

Step two. (Head Extension-Left Rotation) Turn the head to the left from position one until the left ear is pointing to the floor. Remember the head should also still be extended back somewhat.

Step three. (Body Rotation Left) Rotate the entire body to the left until lying on left side with nose pointing to the ground.

Step four. (Sit Upright) In one continuous motion rise from position three until seated at edge of bed.

Perform this series of movements once or twice a day for a week.

That’s all there is to it.

Helpful Tips:

Typically the movements will induce dizziness at every step. Do not rush through the steps. Wait for the dizziness to subside completely at every step before moving on. It is important to not lie down immediately after doing this maneuver. I usually recommend doing this procedure early in the morning, maybe again at noon and then not again until the next day.

If done correctly it should only take three or four days until the symptoms subside.

For an illustrated guide to Epley’s Maneuver click on the West End Chiropractic link below.

http://www.westendchiropractic.ca

Robert Vari B.Sc., D.C.

Langford, British Columbia

Robert Vari is a Chiropractor in private practice who specializes in non invasive, hands on treatment of musculoskeletal disorders.
Robert is the owner of West End Chiropractic, Massage & Acupuncture which serves the residents of the West Shore region of Victoria, BC.

Benign positional vertigo (BPV) is one type of dizziness that is especially disconcerting because it comes on suddenly and with such routine activity. Any sudden tilt of the head – looking up at the top kitchen shelf or washing one’s hair in the shower – can bring on a topsy-turvy sensation. You suddenly feel as if you’re not quite sure where your feet are or where the ground is.

The symptoms of benign positional vertigo are almost infinitely varied. They can be severe or mild, long-lasting or brief, complex or simple, frequent or rare. The good news for patients is that in most cases, dizzy spells can be prevented or controlled with medication, exercise or time.

Inside each inner ear are three semicircular canals that sense rotation of the head and two tiny sacs that sense vertical and horizontal motion. Each sac contains calcium granules – like microscopic grains of sand floating in a gel. When the granules, called otoliths, are pulled by gravity (as in an elevator) or acceleration (as in a subway car) against sensitive nerve fibers, they remind the brain which way it is moving.

If the inner ear is disturbed by injury, infection or a loss of blood supply, the otoliths sometimes float free of their sac and land on the sensor in one of the semi-circular canals that normally senses rotation. The brain then thinks the head is rotating when it isn’t, or when it is merely tilting to one side or moving forward.

The balance system is well protected inside the ear. But the very quality that makes it so effective also makes it vulnerable to being thrown out of kilter by a blow to the head, medication, infection or nerve degeneration.

Diagnosis of benign positional vertigo usually begins with lots of questions for the patient and may proceed through a battery of tests – of vision, hearing, reflexes, nerves, head movement. If there is any reason to suspect a possible tumor, a brain scan is in order. Mostly, the doctor wants to hear exactly when the dizzy spells occur and what they feel like.

Doctors can prescribe a set of exercises deliberately designed to trigger an attack of dizziness so that the brain and inner ear can begin to “unjam” the confusing signals and overcome them.

In some cases, “treatment” of benign positional vertigo involves no treatment at all besides careful monitoring of symptoms until they moderate or go away. In other cases, it’s a matter of adjusting the dose or type of medication a patient is taking for another illness.

If done correctly benign positional vertigo exercises are a useful remedy for vertigo. Vertigo is one of the most common medical conditions to affect individuals. It is among the top three reasons why people seek medical advice. Vertigo is often mistaken for a fear of heights; it is not a fear of heights. It is also commonly confused with feeling lightheaded, like you are going to pass out. Although the sensations can be somewhat similar, they are distinctly different. It can more easily be described as dizziness. Vertigo is defined as you feeling that you or your environment is moving when they are in fact not moving. It is the illusion of movement.

There can be many causes of vertigo. The most common cause is called benign positional vertigo (bppv). Other causes include vestibular neuritis, Meniere’s disease and vestibular migraine. Vestibular neuritis is inflammation of a nerve that plays a role in communicating balance to the brain. Meniere’s disease is a problem with fluid in the inner ear, it has many other symptoms and is very characteristic in the presentation of vertigo. Vestibular migraine is vertigo that is related to a migraine. There are many different treatments for these different types of vertigo but for benign positional vertigo it is best treated by benign positional vertigo exercises.

BPPV is caused by small loose particles in the fluid of the balance organs of the inner ear. The loose particles affect the balance receptors which in turn send aberrant signals to the brain. This results in the perception of movement without any movement actually occurring. Often poorly treated with drugs, benign positional vertigo exercises is most easily corrected with benign positional vertigo exercises when they are taught properly.

BPPV has very distinct characteristics. The episodes of vertigo are brief and in general last under 10 seconds. It will feel like the room is moving around you. Nausea may or may not be present. The triggers of this type of vertigo are very predictable and include movements such as sitting up or lying down in bed, rolling over in bed, bending over like you were tying your shoelaces and looking upwards. Masking the symptoms and providing a false sense of relief is often done with drugs despite the fact that a safer non-drug option exists with benign positional vertigo exercises.

Drugs are commonly given for the symptoms of BPPV. They provide a false sense of relief by desensitizing the nervous system and the feeling of nausea and vertigo. They do nothing to fix the cause of the vertigo, they only treat the symptoms. The use of benign positional vertigo exercises is the only way to correct the root cause of this vertigo. When performed properly they are safe, effective and quick acting. Plus they can be performed in the comfort of your own home.

There is a specific way to go about performing vertigo exercises. If done incorrectly, as seen many times on the internet, they can do more harm than good and actually end up causing you more problems. So take the time to research and make sure you get your advice from a trustworthy source and learn the correct way to perform benign positional vertigo exercises and this will ensure the best chance of fixing your vertigo.

For more expert advice on benign positional vertigo exercises, go to author John Petersone’s website which is all about the quickest way to cure dizziness when lying down.
John F. Petersone
Health Practitioner, Dizziness and Vertigo Specialist and Author of ‘The Cure Vertigo’ ebook.