Vertigo Clinic
Many people have experienced some form of “dizziness” in their life. Dizziness is a broad term often used to describe symptoms such as vertigo, disequilibrium, giddiness, faintness, syncope, light-headedness or imbalance. While these terms get used interchangeably, they represent states of dizziness with distinct and very different symptoms.
Vestibular – Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo, or BPPV, is a very common cause of dizziness seen and treated by ENT surgeon. It is one of the leading causes of vertigo in adults (Bhattacharyya et al 2008) and is very common as we age, thought to occur in up to 50% of vertigo reported by the elderly (Oghalai et al, 2009) and can be the cause of 20% of vertigo seen by General Practitioners in all age groups (Uneri and Turkdogan, 2003).
The symptoms of BPPV are usually quite distinct and are triggered by changes in head position relative to gravity. Typically someone with BPPV will set off their symptoms by a simple movement such as rolling in bed or looking up to hang out the washing or reach for something up high. It is often referred to as “top shelf vertigo”. Symptoms usually have a slight delay of 5-20 seconds between head movement on the onset of vertigo. Episodic vertigo felt by those suffering from BPPV is usually no longer than 60 seconds in duration. It is normal to feel nauseous and a bit “woozy” or off balance in between discrete BPPV episodes.
The cause of BPPV occurs within the inner ear. The inner ear is made up of the cochlea, which is the hearing centre; and the vestibular system which detects rotational, vertical and sideways movements of the head. BPPV occurs when small crystals (otoconia) form and are dislodged (from head trauma, infection, or just age) within the semi-circular canals of the vestibular system. With movements of the head, and incidentally the inner ear, these crystals will move about, giving the incorrect sense that you or the room is spinning.
BPPV can be diagnosed quite simply. Your ENT surgeon will take a thorough history of your symptoms and general health. The examination process is not exhaustive.
