Common dizziness complaints
The room is spinning. When I roll over in bed I get dizzy. When I look up in the shower to rinse my hair, I almost fall down. I’ve tried not to move because I’m afraid I will get dizzy.
These are common complaints we hear in the office when someone has BPPV. BPPV, benign paroxysmal positional vertigo, is the most common cause of veritgo. Inside the vestibular organ (balance organ) are otoconia (tiny calcium carbonate crystals) that shift when we move. Normally, the shift of the otoconia sends a signal to the brain that we are moving, and the eyes respond accordingly to our movement. BPPV occurs when the otoconia fall out of place and move through the fluid-filled canals of the vestibular system, tricking the vestibular system to think it’s moving. During this event, the eyes will actually rotate making the patient perceive that the room is moving, even though the room and the patient are still. BPPV tends to only last a few seconds; however, BPPV can vary in intensity and duration.
By observing the rotation of the eyes, in addition to the patient’s history, an audiologist can diagnose BPPV. BPPV can occur within different canals of the vestibular system, but 81%–90% of BPPV occurs in the posterior canal. The procedure to check the posterior canal is called a Dix-Hallpike. To perform the procedure, a patient will sit on a bed, turn their head to the left (or right) and lean back with their head hanging off the bed. The audiologist will observe the eye movements. If the Dix-Hallpike is positive, the audiologist can perform a CRT (canalith repositioning) to float the crystals back to where they should be within the vestibular system. Within as little as 5 minutes and what seems like a miracle to patients, the dizziness is gone!
So, what causes BPPV?
BPPV can be idiopathic, meaning it occurs for no reason. But it can be caused by head trauma, viruses, surgery, and other problems affecting the head or inner ear. People may feel nausea, off balance, or feel like the room is spinning. BPPV can also reoccur in people who have had it before. Luckily, with proper education and diagnosis, the patient will know exactly what is happening and give their audiologist a call for a quick repositioning!