Vestibular Rehabilitation
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo (BPPV) is characterized by spells of vertigo (a type of dizziness), lasting less than one (1) minute that occurs when the patient moves the head into particular positions. Typically this occurs with looking up, lying down or rolling over in bed. This particular type of vertigo is caused by a problem with the balance system of the inner ear (the labyrinth). It is thought that debris (called canaliths or "ear rocks") break off due to a jarring of the inner ear and subsequently collects in the inner ear. This causes significant dizziness.
How is BPPV diagnosed?
The physical therapist performs a history, physical assessment and balance tests. Special tests, such as the Hallpike-Dix test are performed to determine the side of involvement (confirmed by the observation of torsional nystagmus). If indicated, further diagnostic testing can be ordered - such as an EMG or MRI.
How is BPPV treated in Physical Therapy?
Certain exercises may be helpful with some people. Various kinds of physical maneuvers have proved helpful, such as Canalith repositioning maneuvers. Lastly, it is important to perform a complete assessment of the cervical and cranial base regions to identify any joint or soft-tissue dysfunctions that may be contributing to the patient's symptoms.
Are there any risks with BPPV treatment?
A few patients may experience nausea while the canaliths are being repositioned. It is possible that short term dizziness may occur right after the treatment, but there is usually immediate relief from the "spinning" sensations.
