At this moment, you may be feeling a bit dizzy. Perhaps you went overboard on the egg nog. It tasted so good at the time, but now. . . Or maybe you’re drained from last-minute shopping sprees and working to make small talk with relatives you see only once a year. In this post, I will briefly address a difference type of dizziness that can be quite distressing, yet is easy to treat.
For people with Benign Positional Paroxysmal Vertigo (BPPV), just slightly changing the position of their head causes the world to rapidly spin around them. Although the vertigo usually lasts for less than a minute, the sensation can be quite uncomfortable and frightening. It occurs most often in people over 60 years old and is more common in women.
The diagnosis of BPPV is made by having the patient perform a simple test called the Dix-Hallpike maneuver. It consists of the patient turning her head to one side, then lying back rapidly until she is flat on her back. If BPPV is present, the patient’s eyes will dart back-and-forth sideways (horizontal nystagmus) and the vertigo will recur. From a physician’s perspective, it is satisfying to have a free, non-invasive test deliver such a certain diagnosis.
The treatment of BPPV is similarly low-tech, but effective. In the Epley Maneuver, the practitioner repeatedly positions the patient’s head until the symptoms go away.
All this works because BPPV is caused by the presence of calcium crystals in a part of the inner ear called the semicircular canals. The semicircular canals work as a kind of motion sensor, giving our brain information about the movement of our head. The calcium crystals disrupt this motion-sensing function, throwing us off balance. The Epley Maneuver works by moving the crystals out of the semicircular canal, where they can no longer cause mischief.
Click here for a YouTube video demonstrating how to do the Epley Maneuver.