Tuesday, December 30, 2008

Vertigo: Benign Positional Vertigo

I still have this sensation at times, until now since my doctor diagnosed me to have one. I was freakingly worried that I might have something serious inside my brain! Anyway, my doctor gave me a little information about this, so I thought of sharing it. Perhaps, many has or had it too in the past. Just be sure it is BPV. Don't forget to seek medical help from your doctor.

What is benign positional vertigo (BPV)?
BPV is a spinning sensation of the head (vertigo) brought on by a certain position of the head, usually sudden changes of position. The word "benign" means that it is not a serious condition and is likely to eventually get better.

What is the cause?:
In most peopl, the cause is unknown, but it can follow accidents causing neck or head injuries in some people. There are 2 theories to explain BPV:
  1. A problem exists in the neck, usually a 'kink' in some of the swivel joints of the neck. The neck is connected to the balance centre by special nervous pathways.
  2. There are tiny pieces of floating debris in the balance centre of the inner ear (labyrinth). These little bits of sediment somehow upset the balance centre when disturbed.
What are the sympptoms?:
  • a brief attack of severe dizziness (vertigo), usually for about 10-30- seconds, that comes on a few seconds after a certain head movement.
  • quickly subsiding dizziness.
The changing head positions that provoke an attack can be:
  • tilting the head backwards
  • changing from a lying to a sitting position
  • lying on one ear or the other
  • turning the head to the side with the neck injury
Who gets BPV?
Although it can occur at all ages, the elderly are affected most. It is the most common cause of vertigo in the elderly. Women are twice likely as men to get it. BPV is a surprisingly common problem.

How long does the bouts of BPV last?
Each attack usually lasts less than 30 seconds but can last 60 seconds or so. The attacks tend to come in bursts but usually settle within a few weeks and most people are able to return to work within a week. The bouts tend to come back after months or years, but some people only ever have one attack.

What are the effects of BPV?
There are usually no ill effects in the long run. Unlike some other causes of severe dizziness, there is usually no vomiting, tinnitus (ringing in the ears) or deafness. One has to be careful with driving.

What is the treatment?
There is no special treatment. Drugs are not effective at preventing the attacks. It is basically a matter of allowing the bouts to run their course, but there are some things that may help:
  • Avoid head positions that provoke the attack.
  • Do special neck exercises.
  • Obtain mobilisation treatment to the neck by a qualified therapist.
Sometimes it may be necessary to be referred to a specialist to make sure it is just BPV and not a problem with the circulation to the brain.