How to Combat a Common Cause of Vertigo
If you’ve ever been seasick or carsick, you’re familiar with the unpleasant spinning sensation of vertigo. But you may not know that one of its most common causes is a typically short-lived condition with a long name: benign paroxysmal positional vertigo, or BPPV.
This benign ailment, whose vertigo symptoms are usually worsened by a change in the position of the head—such as rolling over in bed or tilting the head to the side, for example—is quite common: BPPV affects about 5 percent of the population each year.
Vertigo and "Ear Crystals"
Tiny calcium carbonate crystals are thought to be behind the vertigo of BPPV. When these crystals, sometimes called stones, come loose from their normal home in the utricle (part of the ear’s balance system) and travel into the inner ear’s fluid-filled canals, their movement sends false messages to the brain, causing that spinning feeling or sensation of being off-balance.
For some people, this inner ear problem also leads to nausea and vomiting and temporary equilibrium problems. And while the sensations generally resolve quickly (an episode can last three to five days, the vertigo may come and go for up to a couple of weeks), during which time driving may be dangerous.
The older you get, the more likely you are to experience BPPV. The disorder can also come on after a blow to the head—which can knock inner ear crystals loose.
“People also seem to get it more when they are flying or lying down doing exercises like yoga and Pilates, where the head can be far back for an extended period of time,” notes dizziness expert Timothy Hain, M.D., a neurologist and professor emeritus at the Northwestern University School of Medicine in Chicago.
Some research suggests that allergies and respiratory infections can precede BPPV episodes. In addition, as in any disorder where the cause is unknown, fatigue, and stress can trigger BPPV and the resultant vertigo.
Experiencing Vertigo for the First Time?
If you think you might be experiencing BPPV for the first time? Try sitting quietly for a few minutes. This gives the vertigo a chance to diminish and allows you to pay close attention to the sensations you’re experiencing and take the appropriate steps.
“The term dizziness is used to describe a variety of different feelings and sensations—from lightheadedness or near-fainting to vertigo to imbalance—and can mean something different to everyone, says neurologist Orly Avitzur, M.D., M.B.A., Consumer Reports’ medical director. “Because of that variability it’s difficult to provide specific guidance as to how serious it is.
If what you notice is primarily a spinning feeling that seems to be triggered by a change in the position of your head, you can probably wait a few days before calling the doctor—the BPPV is likely to subside in that time. But if your dizziness is accompanied by symptoms such as severe headache, double vision, weakness of one side, slurred speech, chest pain, or heart palpitations, you’re likely experiencing something much more serious than BPPV—such as stroke or a heart problem—and should get immediate emergency attention, notes Avitzur.
Treating This Type of Vertigo
If the distressing symptoms last more than a few days, see your doctor, who will ask about symptoms and may put you in positions that bring on the vertigo to confirm that you have BPPV—there are other types of vertigo as well.
The gold standard for treating BPPV is the Epley Maneuver, in which your healthcare provider will move your head into specific positions designed to move those wayward ear crystals into a less sensitive spot in the inner ear.
“This usually has a 90 to 95 percent success rate after one or two treatments,” says Hain, noting that if it doesn’t do the trick, your healthcare provider will move on to other maneuvers, which position the head in slightly different ways. “And once people have a good maneuver done, they should be fixed, on average, for a year, though we have a few, usually older people, who seem to get it back every three to four months.”
And in the event that the BPPV recurs—as it does for 30 percent of people in the first year after their initial experience with it and in 50 percent over five years—you can probably treat it yourself at home.
“What’s really important for people to realize is that this is a condition that can be fixed quickly; it’s not something you have to suffer with—it’s pretty easy to figure out what you have and pretty easy to fix,” says Hain.
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