BPPV

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TREATMENT OF BPPV DISORDER IN PHYSICAL THERAPY

Ø  WHAT IS BPPV?

         BPPV or Benign Paroxysmal Positional Vertigo is a peripheral vestibular pathology of the inner ear. It is characterized by episodes of dizziness or a sensation of spinning when the head is moved in certain positions. The symptoms could present immediately after the change in position or may be delayed and can last for a few seconds up to a few minutes per episode. 

Ø  ANATOMY OF THE INNER EAR.

              The inner ear consists of the hearing portion and the vestibular or balance portion. The vestibular        portion contains semicircular canals (posterior, anterior, and horizontal canals), and the vestibule which are filled with fluid. A change in head position causes the fluid to move within the canals and stimulate the hair cells (otoliths) and their receptors (otoconia) which send information to the brain to be interpreted.

Ø  WHAT CAUSES THE DIZZINESS?

The vertigo or dizziness from BPPV is a result of abnormal function of the otoconia (receptors) in the inner ear. They send mixed messages to the brain which results in the symptoms of vertigo which can affect your balance. The cause of BPPV can be from MVA, head trauma or in  most cases it is unknown.

Ø  HOW IS BPPV DIAGNOSED?

Special vestibular tests are recommended which can be performed by a neurologist and/or ENT to diagnose BPPV and rule out other possible causes.

Ø  HOW CAN PHYSICAL THERAPY HELP?

A special procedure called the Epley’s Maneuver can be performed in the Physical Therapy office that can assist with moving the otoconia in a way that they no longer cause the symptoms of vertigo. Balance exercises are also used to improve equilibrium to assist with unsteadiness. The Physical Therapist may also provide a home exercise program to train the brain to become use to the symptoms so they become less debilitating.

Ø  CAN THE VERTIGO RETURN?

Yes. The symptoms may go away on their own or with the assistance of a Physical Therapy program but they may also return. BPPV can be treated easily with the proper diagnosis and exercise program but it is important to be aware of the symptoms and consult your physician immediately if the symptoms return.