How Is BPPV Diagnosed?

If you are experiencing dizziness and unexplained episodes of vertigo, your doctor will administer tests to determine what is causing your symptoms. A diagnostic physical exam evaluates eye movements in response to specific head movements. Additional testing such as electronystagmography (ENG) and videonystagmography (VNG) may be used to detect abnormal eye movement; an ENG utilizes electrodes, while the VNG test relies on small cameras.

Fortunately, BPPV is one of the more easily treatable disorders. The standard approach involves a pattern of head movements used to move the calcium particle from the semicircular canal back to the utricle. Called the Canalith Repositioning Procedure (CRP) or the Epley maneuver, this brief procedure takes about five minutes and relieves symptoms in over 85 percent of patients. If CRP is ineffective, patients may undergo surgery; both posterior semicircular canal occlusion and vestibular nerve section have proven effective, but carry a risk of hearing loss following surgery. Treatment with the antibiotic gentamicin and vestibular rehabilitation may also prove successful.

BPPV | Albany ENT & Allergy Services

Q: What Causes BPPV?

It isn’t always known what causes these calcium deposits to break loose, though this is commonly the result of a head injury, inner ear infection, damage from ear surgery or prolonged back position associated with bed rest. Migraines might also play a role. Older patients are susceptible to degeneration of the otolithic membrane related to normal aging.

Q: What Are the Symptoms of BPPV?

BPPV is the most common cause of vertigo. The episodes of vertigo may be severe, but usually lasts for less than a minute. Other symptoms include dizziness or lightheadedness, loss of balance, blurred vision, nausea, vomiting and concentration difficulties.

Benign paroxysmal positional vertigo, commonly referred to as BPPV, is a vestibular disorder that causes vertigo. BPPV is caused when calcium deposits in the inner ear become dislodged from the otolithic membrane and settle in the semicircular canals. Any change in the position of the head causes these tiny crystals to shift, triggering dizziness.

What Causes BPPV?

There isn’t always an apparent cause when these calcium deposits break loose; however, it is commonly the result of a head injury, inner ear infection, damage from ear surgery or prolonged back position associated with bed rest. Migraines might also play a role. Older patients are susceptible to degeneration of the otolithic membrane related to normal aging.

What Are the Symptoms of BPPV?

BPPV is the most common cause of vertigo. The episodes of spinning may be severe but usually lasts for less than a minute. Other symptoms include dizziness or lightheadedness, loss of balance, blurred vision, nausea, vomiting and concentration difficulties.

How Is BPPV Treated?

When a balance specialist treats BPPV, repositioning maneuvers are typically the first step to provide relief from vertigo. These medically developed exercises move the canaliths from the semicircular canals and back into the utricle, where they no longer cause symptoms.

Types of Repositioning Maneuvers

Balance specialists use a few types of repositioning movements to treat patients with BPPV. Each uses slightly different movements and angles to move the calcium deposits from your inner ear canals. Known repositioning maneuvers include:

Canalith Repositioning Procedure (CRP) or Epley maneuver.
Semont-Liberatory maneuver.
Half somersault maneuver or Foster maneuver.

After your BPPV diagnosis, your physician or balance specialist will work with you to develop a treatment plan. The repositioning maneuvers that your physician recommends will depend on your individual case of BPPV. Your doctor will give you clear instructions to help you learn and understand your repositioning maneuver techniques. Some patients need help from a balance doctor to perform their repositioning maneuvers each time, while others may perform the procedures at home.

Call Albany ENT & Allergy Services at (518) 701-2085 for more information or to schedule an appointment.

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