Understanding Vertigo and Its Common Form, BPPV

29 August 2024

Vertigo is often described as a sensation where either you or your surroundings seem to be moving without any actual motion. A specific type called positional vertigo occurs when head movements relative to gravity cause this sensation. One prevalent type of positional vertigo is Benign Paroxysmal Positional Vertigo (BPPV), a disorder stemming from the inner ear leading to repeated episodes of vertigo.

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Key Points about BPPV

BPPV may resolve on its own in about 20% of patients within a month and 50% by three months, though it significantly impacts quality of life and increases the risk of falls if left undiagnosed and untreated.
It predominantly affects adults (18+ years), with two primary types: posterior canal BPPV (85-95% of cases) and lateral or horizontal canal BPPV.
This condition is diagnosed through symptoms and physical exams, specifically the Dix-Hallpike manoeuvre which triggers characteristic nystagmus.
Typical triggers include common activities like rolling over in bed or bending forward. Episodes are usually brief (under a minute), but they significantly affect daily life, leading people to avoid certain movements.

Statistics and Impact

BPPV is quite prevalent, ranging from around 11 to 140 cases per 100,000 population, with much higher estimates in selected groups.
It’s the most common vestibular disorder, especially in individuals between their fifties and seventies.
Women are more likely to be affected than men.
Despite being called “benign,” BPPV’s impact on daily activities and health can be profound, emphasizing the importance of awareness and treatment.

Effective Treatment with Physiotherapy

Physiotherapy offers specialised manoeuvres like the Epley, which help relieve symptoms quickly.
Professional guidance from a physiotherapist ensures that the manoeuvres are performed correctly for maximum effectiveness, reducing the risk of recurrence.
Each treatment is personalised, as physiotherapists can determine the specific type and location of BPPV (posterior or horizontal canals) and apply the most appropriate manoeuvres.
Restore Function Physiotherapy provides a safe environment for performing repositioning manoeuvres, helping patients feel comfortable and reducing anxiety about treatment.
Physiotherapy sessions also educate patients on how to manage symptoms and, if safe, how to perform certain manoeuvres at home.
Beyond manoeuvres, physiotherapists can offer additional exercises to recondition the vestibular system, improve overall balance and reduce the risk of falls.

Reference:

Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Prasaad Steiner RW, Tsai Do B, Voelker CCJ, Waguespack RW, Corrigan MD. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo. Otolaryngology – Head and Neck Surgery 2017, Vol. 156 (3S).

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