Benign positional vertigo (BPPV)

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Each of us during his life at least once, but experienced dizziness. It can occur for a variety of reasons, it can be from normal fatigue or during pregnancy, for example.

There can be many varieties of this pathology, as well as the causes of this condition. One of them is benign positional vertigo. Many have not even heard of such a diagnosis, but this does not protect them from the occurrence of such a pathology. Let's take a look at what kind of disease it is, is it so terrible and can it be de alt with.

Nature of disease

Benign paroxysmal positional vertigo (BPPV) is one of the types of this pathology that can be observed when changing the position of the body or head in space. It is believed that the cause is irritation of the otoliths of the ear, located in its inner part in anticipation of the auditory canal. There are some external influences that provoke rejection of the otoliths from the walls, they begin to move freely, touch the receptors and cause severe dizziness. This leads to disorientation in space, such a condition requires medical attention.

The word "benign" in the name of the disease indicates that this pathology does not apply to serious disorders of the nervous system.

For what reasons does the disease develop?

According to doctors, the accumulation of calcium s alts in the inner ear can lead to the development of this pathology. Statoliths break off from the otolithic membrane and move freely during movement of the body or head, thereby causing dizziness.

Quite often there are cases when this pathology begins to manifest itself in cervical osteochondrosis. But in most cases, if benign positional vertigo is meant, the causes are difficult to establish. Experts in this category include the following factors:

1. Head injuries.
2. Surgical operations performed poorly.
3. Ménière's disease.
4. Some antibiotics, such as Gentamicin, can cause dizziness.
5. The presence of an inflammatory process in the ear canals.
6. Frequent migraines, which are provoked by spasm of blood vessels passing through the labyrinth.
7. For some, even standing still for a long time can cause dizziness.
8. Age-related changes can also be attributed to the reasons.

Benign positional vertigo is most commonly reported in women over 50 years of age. In children and at a young age pathologyalmost never occurs.

Symptoms of the disease

Pathology can manifest itself in different ways, but most often benign positional vertigo has the following symptoms:

1. Often an attack begins its development at a certain position of the body or head.



2. This happens when you bend your neck or turn your head.
3. The duration of the state does not exceed 30 seconds.
4. Patients can usually tell which side they are having an attack with high accuracy.
5. Dizziness is often accompanied by nausea.
6. Attacks can be either single or repeated several times a day.
7. Without provocative movements, dizziness does not appear.

It should be noted that with this pathology there is no headache, earache or hearing loss.

Disease types

Given that the pathological process can develop in any ear, right-sided and left-sided dizziness is distinguished. The mechanism of the disease may also differ, therefore, the following types of it are distinguished:

• Cupulolithiasis. With this form, the otoliths constantly irritate the ear receptors and are more fixed to one wall of the canal.
• Canalolithiasis - otoliths move freely and, if the head movement fails, provoke an attack.

If benign positional vertigo is diagnosed, treatment will depend on the form of the disease and its severity.

Diagnosis of pathology

If you are constantly worried about strange dizziness, which you are not able to explain by any reason, then you should visit a specialist. The doctor will ask about all the symptoms when all the manifestations began.

On the part of the patient, it is required to clarify what provokes seizures and how long they last. The doctor will conduct an examination, which includes various diagnostic methods:

• Dix-Hallpike test. The patient is asked to change the position of the head and torso, and the doctor observes his reaction.
• If in doubt, an MRI is done.
• Cervical computed tomography.

The doctor may refer you for a consultation with an otolaryngologist, neurologist and vestibulologist.

Principles of Therapy

If benign paroxysmal positional vertigo is present, treatment may not be required in every case. It often happens that the attacks themselves leave the person and no longer bother him. But it's also unwise to hope for that, as they could come back with even more power and reps.

In such a situation, there is no escape from therapy, you will have to visit a doctor. Specialists in treatment use several directions, such as:

1. Non-drug treatment.
2. Drug therapy.
3. Surgical intervention.

This issue is decided individually in each case.

Medication-free treatments

You can try to cope with the pathologyand without medication. There is a good Epley trick, which consists in changing the position of the head in a certain sequence. The otoliths exit the semicircular canal into its vestibule. If there is no improvement, then the deterioration also does not threaten after such exercises.

Gives good results if there is benign paroxysmal positional vertigo, vestibular gymnastics. The most famous is the Brandt-Daroff method, here is what it is:

1. In the morning, immediately after waking up, sit on the bed with your back straight.
2. Then lie on either side, and tilt your head up a little.
3. Stay in this position for 45 seconds or until the dizziness subsides, if any.
4. Then repeat on the other side.
5. Exercise enough to perform 5 times in each direction.
6. If dizziness is observed during execution, then all exercises should be done in the evening.

Doctors have the Semont method and the Lempert maneuver in stock, but they are best used under the supervision of a doctor. Exercises are performed at a fairly high speed. Therefore, dizziness is often accompanied by nausea. The specialist monitors the patient's condition and regulates the load.

Here is the Semont technique:

1. The patient should sit down and lower their legs down.
2. Turn your head 45 degrees to the he althy side.
3. Wrap your arms around and in this positionlie down.
4. Keep the position until the vertigo attack stops completely.
5. The same is done on the other side.
6. If there is a need, then all actions are repeated.

Lempert maneuver:

• The patient sits along the couch and turns his head 45 degrees to the affected side.
• The doctor holds the person's head throughout the exercise.

• The patient lies on his back and turns his head in the opposite direction.
• Then turn in a he althy direction.
• It is also necessary to turn the body, from a prone position.
• Head upside down.
• All changes in body position are accompanied by head turns.

As a rule, such exercises give good results, and most patients do not even need further medical treatment if benign paroxysmal positional vertigo is mild.

Drug therapy for disease

Most doctors believe that the use of drugs in such a pathology does not give good results and does not completely eliminate dizziness. But sometimes, to improve the patient's condition, specialists still prescribe medications.

If a diagnosis of benign paroxysmal positional vertigo is diagnosed, drug treatment can have the following effect:

• Reduces nausea.
• Improves emotional state.
• Blood circulation in the brain improves.

If the attacks are repeated frequently and with great intensity, then the patient is advised to rest in bed for a while.

Surgery

In the most severe cases, when drug therapy and vestibular gymnastics do not help, benign positional vertigo has to be eliminated surgically. There are two methods of carrying out the operation:

1. Clogged with wax to prevent fluid movement.
2. The nerve is cut off from the inner ear.

Surgery though will not damage hearing, but often gives complications. Laser therapies are currently being developed and tested.

Currently, benign paroxysmal positional vertigo, which can have any cause, cannot be cured by specific drugs. Therapy is prescribed individually in each case.

Prevention of pathology

There are few diseases that do not have specific preventive measures. But benign positional vertigo is just one of those. It is not known how to protect yourself from this pathology, but some recommendations can be given to patients:

• Do not allow head injuries, at the slightest suspicion of this, an urgent visit to the doctor.
• Protect your ears and avoid injury.
• Training the vestibular apparatus will also come in handy.

Timely undergo treatment of all chronic pathologies. This will help reduce the risk of dizziness developing or recurring

Any deviation from full he alth should not go unnoticed. Timely visit to the doctor will help to avoid complications. As it turned out, even ordinary dizziness can be associated with serious problems.