In many patients, the spinning starts suddenly without any apparent cause. This is called Primary BPPV. However, some conditions can increase the risk of BPPV like:
The incidence of BPPV increases with advancing age. A deficiency of Vitamin D also increases the risk of getting BPPV.
Though the episodes of spinning usually last for less than a minute, patients may feel unsteady or heavy headed.
Certain positional tests like the Dix-Hallpike and Supine Roll tests are performed preferably under the guidance of VNG to diagnose BPPV and identify the position of the displaced crystal. BPPV may co-exist with other vestibular problems which cause dizziness like Vestibular neuritis, Meniere’s disease, Vestibular migraine, etc. Hence a thorough vestibular evaluation is advised.
MRI or CT scans do not help in the diagnosis of BPPV.
Repositioning Maneuvers:
BPPV is a mechanical disorder of the inner ear caused by displaced of calcium carbonate crystals. The treatment involves a repositioning of these crystals back to their original position in the utricle. Various repositioning maneuvers have been described for treatment of BPPV. A few common maneuvers are:
A correctly done maneuver can provide relief to most patients of BPPV.
After the repositioning maneuver, the patient is asked to come for a follow-up visit to make sure that all displaced crystals have been repositioned. Some patients may require additional maneuvers. Some patients experience dizziness after the treatment of BPPV which can be treated with Vestibular Rehabilitation.
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