By Julie Shein, PT, CPT, Point Performance
What is BPPV? It stands for the following:
B- Benign: not life-threatening
P- Paroxysmal: comes and goes
P- Positional: comes and goes depending upon your position
V- Vertigo: spinning
BPPV is an anatomical problem that occurs in the vestibular system (inner ear). When someone has BPPV, the otoconia (calcium carbonate crystals) in the inner ear become dislodged from the utricle (where they belong) and are floating in one of the three semi-circular canals, producing vertigo when you change your head position.
BPPV affects 107 per 100,000 persons per year. The onset is usually insidious— meaning for no apparent reason. Many people wake up with a spinning sensation the first time they experience BPPV symptoms and then continue to have those symptoms each time they lie down, roll over, bend over or look up.
BPPV is diagnosed by a bedside test called a Dix-Hallpike test. The patient is taken through various positions and the medical provider looks for specific eye movements that indicate BPPV, and diagnose which ear and which canal the problem is in. If the patient tests positive for BPPV, treatment is performed.
Treatment for BPPV is very effective. The medical provider performs specific head movements to move the otoconia (crystals) out of the semi-circular canal. Studies show the success rate of treatment at 90 percent effective after 1-3 sessions. On rare occasions, patients required additional vestibular rehabilitation after the BPPV is gone, due to continued mild dizziness or imbalance. Statistically, 50 percent of people have a re-occurance in five years.
Julie Shein, PT, CPT at Point Performance Therapy, is a vestibular certified physical therapist who has been effectively treating patients with BPPV for 18+ years. Dr. John Epley, the founder of the Epley Maneuver (treatment for BPPV) taught Julie how to effectively treat persons with BPPV in the late 90’s. Julie says she loves working with patients with BPPV because the treatment is life-altering. “Patients come into the clinic with dizziness and leave feeling fine. It is a pleasure to make such a difference in peoples lives in such a short period of time.”
Please contact Point Performance Therapy at 301-244-9099 or email Julie at jshein@pointperformance.com if you feel you have BPPV and would like to set up an appointment.
Sources:
Froehling DA, Silverstein MD, Mohr DN, et al. Benign positional vertigo: incidence and prognosis in a population-based study in Olmsted County, Minnesota. Mayo Clin Proc 1991;66:596–601.
Parnes LS, et al. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003 169(7):681-693.
Fife TD, et al. Practice Parameter: Therapies for benign paroxysmal positional vertigo (an evidence-based review): Report on the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008;70:2067-74.