Benign paroxysmal positional vertigo

If you have the sensation that everything is spinning or whirling around you, this is called vertigo. It may occur while standing, walking, or lying down. Depending on the cause, the duration of this type of vertigo attack can vary. Associated ill effects may include feeling dazed or nauseous.

Benign paroxysmal positional vertigo is usually caused by a disorder in the balance organ. Certain movements then trigger vertigo for a short time. Benign paroxysmal positional vertigo is easy to identify and treat. It is harmless, though unpleasant.

Someone having an attack of vertigo has the feeling that everything is spinning around them, like being on a carousel. Benign paroxysmal positional vertigo is usually triggered by the head moving quickly, for example when a person:

• nods or turns their head, or presses it into their neck
• bends down
• lies down
• turns round while lying down
• sits up from lying down.

The feeling of dizziness only usually lasts a short while: between a few seconds and five minutes at most.

Nausea may occur during or after the attack of vertigo, and vomiting too, though rarely.

It seems that loose deposits in the semicircular canals of the inner ear are the cause of benign paroxysmal positional vertigo. The semicircular canals are a ductal system filled with fluid. They form part of the balance organ and they use sensory cells to sense whether and in which direction the head is turning.

How these deposits occur is unclear. They are usually minute stones (otoliths) in the rear of the semicircular canal. When the sufferer moves their head, the free-floating otoliths irritate the sensory cells. Because this faulty information does not match the other sensory perceptions, such as those of the eyes, dizziness occurs.

Rarer causes of vertigo attacks include ear inflammations, skull injuries, blood circulation disorders and being bedridden.

Around two percent of people living in this country are affected by benign paroxysmal positional vertigo at some point in their lives. It occurs twice as frequently in women as in men. Benign paroxysmal positional vertigo occurs most commonly in the 40 to 70 age group.

Repeat, brief attacks of dizziness are typical of benign paroxysmal positional vertigo. But once the stones settle in the semicircular canals and are decomposed by the body, it usually disappears by itself. For this reason, around half of those affected are symptom-free within three months.

Benign paroxysmal positional vertigo is usually easy to identify due to the ill effects and the sufferer’s previous history. It is easily distinguished from other types of vertigo. Doctors normally ask whether the dizziness is constant, comes in attacks, or is caused by particular triggers.

Suspected benign paroxysmal positional vertigo can be confirmed by using the so-called Hallpike test. This involves the doctor helping the patient to quickly move the head and trunk in a prescribed sequence. A case of benign paroxysmal positional vertigo is confirmed if these movements trigger an attack of vertigo.

During the vertigo attack distinctive jerking eye movements (nystagmus) occur. Special glasses (“Frenzel goggles”) can be used during the examination to help detect these.

It is often sufficient to wait until the benign paroxysmal positional vertigo resolves by itself. But there are also optional treatments, such as canalith repositioning. With this procedure, certain movements of the head and body cause the stones to settle so that they stop triggering attacks of vertigo. The doctor will assist the patient in performing the repositioning maneuver. There are also variants of the procedure that can be practiced alone at home. 

Medication for nausea is another treatment. However, these are only required in isolated cases. In cases of severe vertigo, antivertigo medication can temporarily be taken to suppress it. 

For further information on this subject and what to do if benign paroxysmal positional vertigo occurs, go to gesundheitsinformation.de.

Vertigo attacks can unsettle people – particularly if it is unclear whether it is harmless positional vertigo.

In older people in particular, vertigo attacks increase the risk of falling. Reducing activity for fear of the next attack can restrict a person’s everyday life.