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.
