Introduction
Benign paroxysmal positional vertigo (BPPV) is a problem of the inner ear that can cause a spinning sensation when there is head movement. This condition is not a serious one and usually occurs in people above the age of 60 years. If the condition does not improve within six weeks, a minor procedure can be followed, which helps to deal with the signs and symptoms.
What Is Meant by Geriatric Benign Paroxysmal Positional Vertigo?
Vertigo is a condition that causes a false sensation of spinning. Benign paroxysmal positional vertigo is an issue of the inner ear that causes vertigo where there are head movements like tipping the head backward or sitting straight up in the bed.
This condition is not very serious and ceases away within a few days to weeks without any treatment. The symptoms of this condition will be alarming and dangerous for some people over 65 years. The spinning caused by this condition can cause falls, which is the main cause of fractures. People of any age can experience benign paroxysmal positional vertigo, but older people above 50 are more commonly affected.
What Are the Causative Factors of Benign Paroxysmal Positional Vertigo?
Benign paroxysmal positional vertigo occurs when the small calcium crystals known as otoconia move away from their usual location on the utricle, a sensory organ of the inner ear. If these crystals are displaced from their location, then they can move freely in the fluid-filled space. These crystals also move through the semicircular canals that monitor the sensation of the head's rotation. These crystals drift into posterior canals due to gravity, as it is present in the lowest region of the inner ear. When these crystals are present in the semicircular canal, they only result in a problem once there is head movement, like moving the head upward or downward, changing from lying to a seated position, or rolling over the bed.
What Are the Signs and Symptoms Related to Benign Paroxysmal Positional Vertigo?
The typical sign and symptom of this condition is vertigo. The symptoms can vary from person to person and last for about seconds to one minute. The symptoms usually worsen as the person ages due to wear and tear of the ear structures. Some common signs and symptoms are
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Dizziness.
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Nausea and vomiting.
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Balancing issues, which cause people to fall due to spinning sensations.
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Lightheadedness.
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Blurred vision.
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Nystagmus, quick and involuntary eye movement.
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Unsteadiness.
What Are the Other Causes of Benign Paroxysmal Positional Vertigo?
Some conditions tend to trigger vertigo; some are
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Mild to severe head injuries.
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Placing the head in the same position for a long time.
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Rough trails of the bike ride.
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Intense aerobics.
This condition can also be triggered by other inner ear issues like
This condition is where the inner ear's labyrinth membrane gets inflamed.
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Vestibular Neuritis:
This condition is caused by inflammation in the eighth cranial nerve's vestibular part.
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Acoustic Neuroma:
This is a noncancerous tumor in the vestibular nerve responsible for balance.
How Is Benign Paroxysmal Positional Vertigo Diagnosed?
A detailed history of the patient is recorded. Benign paroxysmal positional vertigo diagnosis is confirmed by nystagmus, which is rapid eye movement and vertigo symptoms. A diagnostic test is conducted to confirm Benign paroxysmal positional vertigo, called as
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Dix-Hallpike Maneuver:
Initially, when the patient is sitting up, the head is tilted to a 45-degree angle to any one side. Then, the person's head is laid quickly backward over the examination table. When this movement is done, the patient experiences vertigo and nystagmus, and this response confirms the presence of benign paroxysmal positional vertigo.
How Is Benign Paroxysmal Positional Vertigo Managed?
Management of Benign paroxysmal positional vertigo does not require any medication or surgery. This condition is treated through some physical exercise that aims to reposition the crystals present in the semicircular canal responsible for the occurrence of vertigo. Certain physical exercises are recommended to help the crystals move out of the semicircular canal. Once these exercises are performed, the person is asked to walk carefully. They should avoid certain head movements like bending forward or backward. Lying on the affected side should be avoided for several weeks.
The steps to be followed while performing the exercise
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Step 1:
The person should sit on a bed or table and tilt the head to 45 degrees on the affected side.
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Step 2:
Quickly move backward as the head is turned towards the affected area, and lie back with the head at the edge of the bed or table. Continued in this position for a minute or till the symptoms cease.
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Step 3:
Move the head quickly to the unaffected side without raising the head. Hold on to this position until the symptoms are reduced.
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Step 4:
Roll to the side and turn the heat to 90 degrees, like in step 3, as the nose faces the floor. Hold to this position until the symptoms fade away.
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Step 5:
Place the chin tucked in and sit in the same direction the body is facing.
Usually, benign paroxysmal positional vertigo can go away without treatment or medication. If the symptoms reoccur, the doctor will instruct what needs to be done. But in rare cases, the person with severe nausea and vomiting symptoms is prescribed anti-nausea medications. In some other rare cases, surgery is recommended by doctors to block the posterior semicircular canal, but there are risk factors associated with hearing loss.
How Can Benign Paroxysmal Positional Vertigo Be Prevented?
The occurrence of benign paroxysmal positional vertigo cannot be prevented, but the symptoms can be managed by performing repositioning exercises. To avoid any accident caused due to this condition, be extra careful while walking, wear a helmet while riding a bike, or indulge in any contact sports.
Conclusion
Benign paroxysmal positional vertigo is an inner ear condition that causes vertigo. This condition is commonly seen in elderly people. This condition is not problematic, but it can impact the affected person's life as it causes spinning of the head, dizziness, and balance problems. This condition does not require any treatment as it ceases on its own; people who experience more episodes of this condition can manage the symptoms through specific exercises.
