Benign Paroxysmal Positional Vertigo Treatment (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is characterised by the sudden onset of vertigo episodes that are triggered by head movements. Vertigo is a subjective, external experience of rotational movement. This happens regardless of any input from the environment.

At the Gold Coast Headache and Migraine Clinic, we assess and find out if a sensitised brainstem and dysfunction in your upper cervical spine are the cause of your BPPV. Then we are able to treat this using our world-leading, modern techniques. If this is the case, we can start treatment immediately.

With our clinic’s groundbreaking treatment for BPPV we usually see the condition effectively treated within the first 6 sessions, as we do with 85-90% of our patients. Book an appointment today.

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Understanding BPPV Symptoms

What are the symptoms of BPPV?

It is estimated that vertigo patients are diagnosed with BPPV 17-42% of the time and a yearly prevalence of 11-64 people per 100,000 per year. The main symptoms that BPPV patients experience are:

Vertigo

Dizziness

Nausea

Vomiting

Nystagmus (rapid, unidirectional and involuntary eye movements, unnoticed by the patient)

BPPV is easily diagnosed following physical examination and medical history collection by your health professional, scans are very rarely required. The physical tests will assess structures in your inner ear called cannula, which are known to be the cause of BPPV.

What causes BPPV?

BPPV is a common disorder affecting the otolith organs inside the inner ear. These otolith organs are essentially the inner ear balance system, designed to detect the gravitational and acceleration forces in our head during movement so that we can adjust and stay upright.

BPPV occurs when these organs become impaired through:

Inner ear disease (such as vestibular neuritis)
Head injury
Vestibular system degeneration from ageing
Damage caused by an inner ear disorder

The balance organs will detect head movements that are normally fine, and react by causing symptoms of vertigo. This lower threshold for quite severe symptoms of vertigo can be quite debilitating for BPPV sufferers.

BPPV Theory

There are two main theories regarding the cause of BPPV; both are regarding the endolymph flowing through the semicircular canals of the otolith organs:

The ‘Cupulolithiasis Model’

This theory suggests that matter within the endolymph becomes attached to the cupula, or the sensory organs located in the semicircular canals.

The ‘Canalithiasis Model’

This theory suggests that there are free-floating particles within the endolymph that are detected by the cupula, this abnormal detection is registered and vertigo is experienced as a result.

The standard treatment for Posterior Canal BPPV, the most common type of BPPV, is the Epley Manoeuvre. This canalith repositioning procedure involves having the patient’s head turned to a series of positions that are designed to shift any matter in the semicircular canals (most commonly the posterior semicircular canal) so that they no longer trigger symptoms. This manoeuvre is easy to perform at home once taught by a health professional, however it is common that symptoms persist after this procedure is performed. It’s worth noting that following Epley Manoeuvre treatment the patient should avoid tilting their head backward and forward as well as sleeping on the side of the affected ear for several days.

Organise Your Initial Assessment

About The Assessment Stage

What To Expect During The Assessment

1. Comprehensive and in-depth examination

We will perform a thorough and in-depth examination to identify all of the factors that may be related to your headaches and migraines. We will focus particularly on your upper cervical spine in our assessment.

2. Ligamental stability and vertebral arterial tests

In order to ensure the highest level of safety is maintained, we routinely will assess the stability of the important ligaments in your upper cervical spine, prior to any assessment or treatment.

3. Temporarily reproduce your headache and migraine symptoms

During our assessment and treatment process, we will be applying gentle and specific pressure to your upper cervical spine in order to temporarily reproduce your headache symptoms. This helps us to identify the specific cause of your headaches.

More about BPPV

Living with BPPV

In a lot of the patients that we see, they experience all of the symptoms of BPPV, but the results are often unclear when they undergo testing or they do not respond effectively to the standard treatment of BPPV. In these patients, it is likely that sensitivity in the central nervous system, specifically the brainstem, is the true cause. The afferent vestibular nerve sends normal information that reaches the sensitised brainstem, this information is wrongly interpreted as a threat and vertigo is experienced.

Symptoms of BPPV

BPPV is a condition that affects the inner ear. Small calcified crystals called otoconia can become dislodged in the canals of the inner ear, which can alter your body’s perception of balance and head position, causing vestibular symptoms like dizziness (vertigo). The similarity of these symptoms to those of vestibular migraines mean that sufferers of BPPV are commonly misdiagnosed as vestibular migraine sufferers by health professionals.

Many of the patients that we see at Gold Coast Headache & Migraine Clinic have all of the symptoms of BPPV, but do not respond to treatment or the physical testing cannot accurately diagnose them.

Different types of BPPV

Benign paroxysmal positional vertigo (BPPV) is primarily classified into different types based on the affected semicircular canal. The different types of BPPV are as follows:

Posterior Canal BPPV (PC-BPPV):

This is the most common type, where the displaced otoconia are located in the posterior semicircular canal of the inner ear.

Anterior Canal BPPV (AC-BPPV):

Less common than posterior canal BPPV, this type involves displaced otoconia in the anterior semicircular canal.

Horizontal Canal BPPV (HC-BPPV):

In this type, the otoconia are located in the horizontal semicircular canal. It’s less common but often more complex to diagnose and treat.

Multicanal BPPV:

This occurs when the displaced otoconia are found in multiple semicircular canals, as opposed to just one affected canal. This can cause complications in accurate diagnosis and benign positional vertigo treatment.

Our BPPV Clinic Treatment

The Dix-Hallpike test and the supine-roll test has been developed to detect faults in the posterior and horizontal semicircular canals respectively. These tests are designed to create a change in fluid -dynamics and the detection of the endolymph in the otolith organs.

Vertigo is experienced in a positive test and the therapist will observe for the presence and direction of nystagmus, or rapid beating of the eyes. It is very rare that the superior semicircular canal is at fault during BPPV, however if it were to be, the Dix-Hallpike test would again be positive, and the therapist would observe upwards beating nystagmus in the patient.

BPPV Treatment Gold Coast

I've tried everything, what else can I do?

Our patients have had mixed results with the Epley manoeuvre, some have tried motion sickness medications, some have even had surgeries, like neurotomies or posterior canal occlusion, in attempts to reduce their symptoms. Some of these methods have had some effect, though they have mostly been minimal or short-lived. This is likely because, in these cases, they haven’t been properly assessed to determine if a sensitised brainstem is the true cause of their symptoms.

In cases where we have assessed and found that a sensitised brainstem and dysfunction in your upper cervical spine are the cause of your BPPV then we are able to treat this using our world-leading, modern physical therapy and vestibular rehabilitation techniques. If this is the case, we can start treatment immediately, and we usually see rapid results, within the first 6 sessions, as we do with 85-90% of our patients.

The best part is that our BPPV treatment is safe, gentle, medication-free and non-invasive!

What our clients have said

Excellent

4.9

Andrea Duffy

After being diagnosed with Sunct Trigeminal Neuralgia I was seeking treatment without drugs. After 2 months of treatments with Kevin I'm now pain free. Well worth the effort for a fantastic result, thanks team.

Sarah Jane

Seeing Doug & the team at BHMC has really changed my life, and I’m really grateful for the ongoing care and support. I used to think I had bad vertigo & I would feel dizzy and faint and light headed and nauseous all day everyday and couldn’t work, couldn’t do housework, couldn’t walk my dog, could barely stay standing to shower all because I had been walking around with an unaligned c2 &c3 in my neck due to years of bad posture and constantly hunching over at my desk at work or my head down looking at my phone all day. Migraines 2-3 times a week, constantly feeling pressure in my head and sharp pain, unable to sleep a full nights sleep, and not reacting well at all to prescription medications like valium, replax, and others. I finally got health insurance and headed into BHMC and in the 1st consultation, I was advised of a detailed diagnosis and knew I was in the right place to get help. I’d been struggling everyday for over a year with migraines, had to quit jobs, and was mentally struggling due to these physical symptoms, it was awful. I really wish i’d gone to get physio sooner! Please go and see BHMC, I have been in physio for less than 6 months (probably 10-15 appointments) and have never felt better and more stable. If you go here, try the sessions, buy the pillow, sit up straight, do the exercises, I promise you’ll be better off! Doug has been amazing & so professional, he really knows what hes doing. All the office team is lovely as well!

Samuel Cox

I have been seeing Dr. Woo for about 6 months now and he has been helping me manage my migraines fantastically. I used to get on average 2 migraines a month, now I have gone 4 months with no migraines. The cause of my migraines was very quickly diagnosed and its clear the team here prioritise the goal of self management, not the reliance on medication and continuous appointments. Can recommend to anyone who suffers from Chronic Migraines, it may well be a life changer for you.

Han Wang

My headache problem has been lasting for many years and I suffer from it more frequently from the last 18 months. The quality of my life before treatment was affected tremendously. I simply couldn't enjoy lots of activities when headache attacks occur. I started my headache treatment from the last few weeks and it has been very effective. It is very obvious to how I feel around my neck before and after the treatment. I haven't had any headache episode since. I highly recommend this clinic and the physician named Douglas. He is courteous, gentle, very caring and most amazingly very knowledgeable and skillful. He was able to diagnose my headache issue and provide detailed explainations about my treatment plan and future preventative guidance. I wish I had found this clinic earlier and for anyone who is suffering from headaches you should definitely give it a go. Overall it's a nice and clean clinic, easy public transport and parking. Helpful and friendly admin staff too. Thank you Brisbane Headache and Migraine Clinic Sunnybank Hills.

Celeste Cover

My healthy 7yr old son out of blue started having debilitating migraines about a year ago. Being a nurse I ensured we ruled out anything nasty by doing MRI and seeing specialist. But we kept getting no definitive answer as to why they were reoccuring. Being so young treatment options are limited until 12yrs of age and every episode we would end up at the emergency department with then specialist follow up appointments. Something had to change. I then came across a fellow work colleague (GP) whom referred me to Brisbane Headache and Migraine Clinic. My son has been seeing David now at the spring hill clinic for over 2mnths, where he has worked absolute wonders. My son has had no episodes of a migraine to date yet. David also ensure he educates his clients during the appointment, follows up with exercises and resources for you to use at home as well, easy management plans and a diary to track and see patterns as to why a migraine maybe triggered. I would highly recommend these clinics to anyone suffering. The amount of knowledge and expertise by the staff is amazing. I will always be praising them for the help with my son.

Sahan Amarasena

I have been seeing Sascha for about 3 weeks now. Thanks to Sascha, I have gone from 4-5 headaches a week to being headache free for over a week now. He is very knowledgeable and was quick to diagnose my problem. The treatment plan has been very clear and easy to follow at home. We have addressed all factors that are contributing to my headaches and I am confident of keeping my headaches under control thanks to the tools Sascha has taught me. Highly impressed with the team. They have been very professional, friendly and helpful throughout and been impressed with their customer service. Highly recommend these guys if you are someone who has been suffering with headache for a long time like myself.

Ana Uppman

Mattias and the staff at the clinic are wonderfully helpful and friendly. Mattias in particular helped me to manage chronic headaches and sinus effectively and naturally which has provided a huge amount of pain relief to me especially after so many years of discomfort. Thank you so much Mattias and staff.

Jesse Tamblyn

Diagnosed with Vestibular Neuritis, quickly turned into vestibular migraines of a hellish level. I was hallucinating constantly, pretty much 24/7 for a entire year. With no regular symptoms of a migraine other than extreme light sensitivity, my doctor ordered all the tests, nothing was helping. After a few sessions with Sasch I have zero symptoms and none of my previous triggers are triggering any hallucinations/migraines. Sasch is increadibly skilled at what he does and is very passionate about his clients. I am forever in a debt of gratitude.

kynan jones

I have had cluster headaches on and off for two years now and have had no clue what to do about it, I stumbled across Brisbane migraine and headache clinic, decided to give it a go and I could not be happier with the results from Mattias. My symptoms have dropped by an easy 90% and I can enjoy my days again. Thank you Mattias and thank you Brisbane migraine and headache clinic.

Carter Bennett

So far my treatment at the Headache and Migraine clinic has been very helpful. As someone who experiences migraines often enough, I can say with confidence that after only a few months of treatment with practictioner Mattias, the frequency and severity has been reduced. Still a ways to go till Im migraine free, but I can say with confidence that this very interesting form of treatment works.

ARCHANACHOWDARY NALLAPANENI

David is really wonderful and he is a magician. I've been suffering from migraine headaches for past three years after I met David, and his treatment is like a miracle. I've been on treatment for five weeks now and haven't had any headaches. Thank you heaps David

Rachel de Vera

Best place to overcome your headache pain. This clinic will give you treatment to make your life free from migraine.

Luke Shanley

Ariel from Brisbane Migraine & Headache clinic was the only person that actually helped with my migraines. After seeing doctors & neurologists to no avail i decided to give it a go. I'm able to see friends, nieces & nephews again and working full time. This seemed impossible just over 2 months ago when I first started treatment. Gave me my life back.

Danielle Raftopoulos

I've seen Ariel for neck, back and knee pain/ injuries in the past. She does an excellent job with releasing muscles through dry needling and acupuncture which has relieves pain. Ariel provides exercises to do at home which are helpful. I've also seen all the other physios at the clinic. Highly recommend it.

Pawan Sandhu

I was suffering with bad migraine from last 13 years. Then I heard about Brisbane headache centre. I consulted with Dominic he is very professional and nice Physio. He find out the triggers and started my treatment since i seen him first till now I haven't had any headaches. I highly recommend people if you suffering with headache and migraine please go and consult with the team. Thanks Dominic.

Brooke O'kell

I have had an amazing experience with Ariel at the clinic. I went there in horrific pain after been diagnosed with Trigeminal Neuralgia and I was taking 12 nerve pain tablets a day. The clinic was recommended to me by a friend and I'm so glad I gave them a try because now after a couple of months I am pain free and down to one nerve tablet a day. It's hard to explain really how grateful I really am now to be spending Christmas with my family pain free after not been able to leave the house without crying in pain. I'm would give them 100 stars if I could and I've already recommended Ariel to some friends who suffer migraines. Thank you for everything Ariel your an amazing and lovely lady who really changed my life.

Cathy Biles

I have suffered from migraines for 30 years and I have found that the treatment that I am having at Brisbane Headache and Migraine Clinic is the most effective way I’ve found in preventing a migraine. I have been having treatment with Mattias for around 4 months, and at this stage I still do get some migraines, but they are getting a lot less frequent than they were before I started having treatment. Mattias is very understanding and explains each step of the treatment very thoroughly.

Candy Beanland

Dominic is a very polite person who has helped me a great deal with my migraine headaches. I am very grateful to him.

Emma Zonca

I've had a great experience being treated by Dominic. I was recently diagnosed with Trigeminal Neuralgia and my symptoms have now massively reduced. The care and education I have received have been excellent. All staff have been welcoming and very lovely to deal with since my first appointment. I highly recommend Brisbane Headache and Migraine Clinic.

Ebony Smith

I've been receiving treatment from Mattias for a little over two months now and I cannot recommend this practice enough!!! I have been struggling with Migraine headaches and terrifying aura symptoms for 10+ years and have tried absolutely everything (from medications, diets, all sorts of treatments and multiple specialist/neurologist appointments) in order to eliminate, ease or simply manage the pain. Thank you to Mattias and the wonderful team at Brisbane Headache and Migraine Clinic for listening to my struggles with pain, understanding my issues, applying the right treatment that my body was receptive to...and most importantly.... they gave me a free jar of mints! What a DEAL! 10/10 recommend.

Cassandra Guse

2 months ago debilitating migraines were driving me crazy - and I finally snapped and called this clinic after 3 years of spending most of my spare time just resting and re-habbing my head and neck between work. I started treatments with Dominic immediately. And I am amazed to report that I haven't had a migraine since! I wish I had done it years earlier. Dominic is pleasant, thorough, very knowledgeable and holistic in his advice, picking up on things which seem unrelated but were likely contributing to my headaches - and explains everything every step of the way. I can't recommend him highly enough.

Laura O'hearn

I have only been seeing Dominic from Brisbane Headache and Migraine Clinic for three weeks, but the change in my migraines has been dramatic. I have struggled with chronic migraines for over 20 years and I did not find daily medication helpful in controlling them. I wish I had known about Brisbane Headache and Migraine Clinic sooner as this has been a life-changing experience.

Paul Hewitt

There could not be too much praise for the services and results produced at this Centre . I was suffering clusters of migraines and other neck pain. Went to Doctor, more medication! Decided there has to be a better way. Googled the Headache and Migraine Centre, met with Mattias, and Helen , a few visits and the relief was significant . Small business could take a lesson from their efficiency as well, Admin staff are all over everything, helping you to make appointment times that suit you. If you had or having similar issues to mine..........Just go there .

Chimorne Bekker

Special thanks to Dominic for treating me at the Brisbane Headache and Migraine Clinic. I have had roughly 11 sessions at the clinic and have been headache & migraine free for two weeks today. This may not seem very long, but it is for someone who experiences an attack every second day. My treatment is still ongoing, but the results are already promising. I also have to mention that Dominic was the first specialist to notice that my C2-C3 cervical vertebrae were rotated/disturbed and recommended that we realign the vertebrae and desensitise my brain stem. This was a relief as specialists in the past have diagnosed me with anything from ethmoid sinusitis and occipital neuralgia to labelling it as “psychosomatic“. I would highly recommend anyone suffering from migraines/headaches to arrange a consultation with Dominic.

Megan Tilley

After about 5 weeks of constant headaches, in complete desperation I contacted BHMC and within 4 sessions with Mathias, my headaches significantly reduced in severity and duration. Highly recommended!

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