What it is
One of the most common inner ear disorders is BPPV (benign paroxysmal positional vertigo). This type of vertigo is caused when tiny calcium crystals become dislodged in the inner ear. These crystals typically function to sense gravity within the vestibular system, so when the crystals are not in their proper place it results in the brief spinning sensation of vertigo.
Although symptoms can vary, most people experience vertigo only when moving their head in certain ways, most commonly when looking up or rolling over in bed. The symptoms usually disappear when the head is still, although some people can experience mild symptoms or sensations of motion or fogginess. BPPV is diagnosed in the clinic by placing the head in certain positions and watching for specific eye movements.
How to treat it
In general the crystals often dissolve on their own, but if symptoms last longer than a few days, the crystals can be moved back where they belong by maneuvering the head through a sequence of positions. Currently, there are no medications for treating or preventing BPPV.
Several maneuvers (Epley, Brandt-Daroff, Cawthorne and BBQ roll) have been developed that effectively reposition the crystals. The maneuvers can be performed either in the doctor’s office, or they can be learned and performed at home as well. It can take a few maneuvers to return the crystals to their proper place, and then the symptoms will dissipate.
To prevent the crystals from dislodging again, you should keep your head upright for half an hour after performing each maneuver. This allows the crystals to attach to their proper position. In addition, for severe cases, you may want to consider sleeping upright over the next 48 hours.
In rare cases when the maneuvers do not relieve the symptoms, or if the BPPV recurs frequently, a surgical treatment option called “posterior semicircular canal occlusion” may be recommended to correct the problem.
