What is Vertigo?
For those of you who have vertigo, you know that it is one of the most off-putting, uncomfortable, and wholly miserable conditions that one could imagine. It is usually defined as a sensation of spinning, where you are still – but the world spins or moves around you. For those of you who have never experienced vertigo, imagine standing on the deck of a small boat in the middle of rough seas. True vertigo is characterised by unsteady, world spinning, nauseating motion sensitivity. Almost like sea-sickness, but not quite.
There are many potential causes of vertigo – from high blood pressure or viral infection to blood vessel blockages, tumours, or migraines. And yet the most common causes of vertigo are vestibular (ear) issues[i]. One in particular, called ‘benign paroxysmal positional vertigo’ (BPPV) accounts for 20-40% of all vertigo, and this rises to 50% in people older than 60 years of age[ii].
Common symptoms of BPPV
The most common symptoms of BPPV are relatively easily identified, and are found in the patient history.
- Firstly, the episodes of vertigo usually occur when changing position – typically moving in bed, bending forwards, or turning the head.
- Secondly, the vertigo should subside after 30-60 seconds of being in the new position. Importantly, BPPV should never occur with weakness, pins and needles, visual changes (e.g. partial blindness), or trouble speaking/swallowing.
If you have any of these symptoms, go to the emergency department of your nearest hospital or call an ambulance as you may have a ‘central’ (brain) cause of vertigo.
So what exactly is BPPV?
Well, to put it simply BPPV occurs when a little calcium crystal in the ear falls into somewhere it doesn’t belong. Imagine if you were driving your car and a little screw came loose and fell into the engine – things might start to go wrong. Just like the car, when this little crystal (called an otoconia) falls into the semi-circular canal of the ear (where it doesn’t belong), things start to go wrong.
Specifically, the information your brain receives about head position and movement begins to clash with what the eyes and other muscles/joints are saying. The consequence of this is vertigo, as the brain struggles to understand conflicting information coming from your ears and other body parts.
How do we treat it?
Luckily the treatment is simple and effective – put the calcium crystal back in the right place! The most effective method of doing this is the Eppley Manoeuvre, which can be performed by an appropriately trained professional (a physiotherapist or doctor who is familiar with treating BPPV). Within 2-3 treatments you should notice a complete or almost complete resolution of your symptoms[i].
So the next time you or someone you know has symptoms of BPPV-related vertigo, impress them with your knowledge and direct them towards someone who can help. They will appreciate the advice!