If you’ve been feeling dizzy and off-kilter lately, your inner ear could be to blame. Balance is controlled by a tiny sensory system in your inner ear called the vestibular system, and in some cases, it can malfunction, sending your world spinning, literally.
“The most common vestibular condition that causes dizziness is benign positional vertigo, also known as BPV,” says Danko Cerenko, M.D., an otolaryngologist (ear, nose and throat physician) at Piedmont. “Three out of five people who are diagnosed with an inner ear problem typically have BPV.”
Symptoms vary from person to person. Some people with BPV have no symptoms, while others get sick to their stomach because they are so dizzy.
What causes benign positional vertigo?
The vestibular system of each ear consists of three semicircular canals, all filled with fluid. Other structures in the inner ear (saccule and utricle) contain tiny crystals that help the body register head movements and linear acceleration. These crystals can migrate and become displaced in one of the vestibular canals, causing abnormal fluid movement in the inner ear. This leads to sensitivity to changes in head position, causing a dizzy sensation.
Who is at risk for benign positional vertigo?
Aging is the leading cause of BPV. Just like hearing and vision wane with age, so do vestibular senses. Those who have experienced a previous head injury (e.g., a car accident, sports injury, fall, etc.), are also prone to get BPV.
Symptoms of benign positional vertigo
People who have BPV commonly experience short bursts of a spinning sensation and even feel nauseated when they change positions quickly, such as when reaching for something on a high shelf, bending over, reclining in a chair, lying down or rolling over in bed at night. Dr. Cerenko describes BPV as a false sense of rotation.
“This spinning sensation usually lasts anywhere from 10 to 15 seconds and can happen multiple times a day for a few days, a few weeks, or even years. However, it is in no way life-threatening or a sign of other health conditions,” he assures.
Another common symptom is involuntary eye movement.
“When you look into someone’s eyes who is experiencing an episode, their eyes are usually jerking in an abnormal symmetrical movement, which may last 10 to 15 seconds,” Dr. Cerenko says. “They will almost always want to reposition their head to alleviate this sensation.”
Treatment options for BPV
There is a method called the Epley maneuver, which is a repositioning technique that forces those tiny crystals out of the vestibular canal, restoring a sense of balance. This procedure involves rotating the head in a sequence of positions and should only be performed by a physician or trained medical professional.
Studies have shown the Epley maneuver can bring permanent relief to 70% of BPV patients. Only about 30% of patients will have recurring symptoms.
“There are many different things that can cause dizziness, including other inner ear conditions, cardiovascular and neurological system conditions, as well as some types of medications,” Dr. Cerenko says. “That is why testing is critical to determine the exact cause of your dizziness or vertigo.”
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