Benign positional vertigo, or BPV, accounts for 20 percent of all dizziness and up to 50 percent of dizziness in older people, according to Northwestern University Medical School professor Dr. Timothy Hain. Although not life-threatening, symptoms can be disconcerting and inconvenient, making you alter your normal activities. Head exercises might help reduce symptoms, hasten recovery or even cure the disorder.
Identification
Benign paroxysmal positional vertigo, or BPV, causes an abnormal sensation of motion such as spinning, often accompanied by lightheadedness, imbalance and nausea. In mild cases, symptoms occur primarily with neck extension motions such as looking up or rolling over in bed, and last for a few seconds or up to a minute. In more severe cases, any movement will cause dizziness. The reason dizziness occurs is due to crystals inside the otolith organs in your ear becoming dislodged and moving into the ear canal. The most common cause of BPV in people under age 50 is head injury, whereas in people over 50, the most likely cause is a degeneration of the vestibular portion of the inner ear.
Exercise Benefits
Particle-repositioning maneuvers help the crystals migrate out of the canal into a section of the ear where they won’t cause vertigo. These exercises are successful in curing the disease with just one treatment in about 80 percent of patients, and early successful repositioning can reduce the incidence of residual dizziness in others. If the maneuvers don’t work, your doctor can prescribe vestibular rehabilitation therapy exercises to retrain your brain to recognize and process signals from your ear/brain balancing system to coordinate with vision and movement.
Types
There are two common treatments for BPV, performed in the doctor's office or at home: the Semont maneuver, in which you move rapidly from lying on one side to lying on the other, and the Epley maneuver, which involves sequential movement of the head into four positions for roughly 30 seconds each. If these exercises don’t work, your doctor might suggest Brandt-Daroff exercises. Sit on the edge of the bed with your legs hanging over the side, quickly lie down on your right side and turn your head 45 degrees to the left; hold for 30 seconds, return your head to the upright position and repeat on the other side.
Considerations
About one-third of all patients have a recurrence in the first year after treatment, with about half of patients having a recurrence within five years. Take precautions to avoid serious injury if you experience an episode of dizziness, such as sitting down immediately when you first feel dizzy. Use good lighting if you get up at night, walk with a cane for stability if you are at risk for a fall and consult your doctor for further instructions. In rare cases, surgery might be required, and there could be loss of hearing in the affected ear.
References
- University of Maryland Medical Center: Benign Paroxysmal Positional Vertigo
- Dr. Timothy Hain; "Benign Paroxysmal Positional Vertigo"; February 2003
- MayoClinic.com: Benign Paroxysmal Positional Vertigo
- Vestibular Disorders Association: Vestibular Rehabilitation Therapy
- “Journal of Clinical Neurology”; "Residual Dizziness after Successful Repositioning Treatment in Patients with Benign Paroxysmal Positional Vertigo"; Dr. Jung Im Seok; September 2008
