Benign Paroxysmal Positional Vertigo – A Surprisingly Common Condition

Benign paroxysmal positional vertigo, or BPPV, is the most common cause of vertigo – a kind of dizziness that involves a sensation of spinning or swaying, and affects about 2.4% of people2. It’s a mouthful to say, but what is it, really?

Benign, means that it is not, by itself, life threatening1. But while it may not kill you outright, this debilitating condition can wreak havoc on your ability to function on a day-to-day basis and it can make you vulnerable to life-threatening falls and injuries.

Spinning Out of Control

BPPV attacks come on suddenly, in the form of abrupt fits ranging from mild to violent, that occur when the sufferer moves quickly, such as standing up, sitting down or even doing something as simple as turning over in bed. The positional component of the condition, activating the position sensors of the inner ears.

The cause for BPPV is a mystery in most cases and may vary from person to person.
The condition has been noted to occur following trauma and inner ear infection, and is also seen with greater frequency in conditions such as diabetes and osteoporosis and when patients are incapacitated in hospital beds for prolonged periods of time 2.

However, regardless of the originating incident, BPPV manifests when small calcium crystals that are part of the inner ear’s balance and position sensing apparatus, become dislodged from the where they normally reside.

When a healthy person moves about, the crystal-gel layer moves across sensory nerves, stimulating them to send positional information to the brain. However, in BPPV, dislodged crystals travel freely within the fluid of the inner ear canals impairing the normal fluid movement in the inner ear structure and sending incorrect signals to the brain. The incorrect signals disagree with the actual direction of movement of the head and body and also with the visual information the brain is receiving2.

At the onset of an attack of BPPV, the misinformation coming from the ears overpowers the visual information coming into the eyes and pulls the eyes toward the incorrect positional information. This makes it impossible for the sufferer to direct their gaze where they choose and, instead, the eyes develop a rapid back and forth jerking motion, known as nystagmus. Once the person stops moving, the dislodged crystals settle down and the symptoms subside.

While episodes of BPPV usually last a minute or less, in that short amount of time the symptoms can be quite intense, causing complications such as blurred vision, falling and vomiting. In extreme cases, excessive or frequent vomiting can lead some BPPV sufferers to develop dehydration.

Treatment Options

Treatment for BPPV usually involves various positioning maneuvers of the head3.4 that are designed to guide the dislodged crystals back to their proper locations. About 50% of the time, once repositioning is achieved the crystals stay in place2. In the event of a recurrence the maneuver can be repeated by a professional vestibular therapist, or, in some instances, patients can be trained to perform the maneuver by themselves.

In conjunction with the physical maneuvers, some BPPV patients are able to maintain their symptom-free status and prevent BPPV symptoms by supplementing with certain vitamins and herbs including the B-complex vitamins B1, B2 and B6 and the herb ginkgo biloba5. These and other natural substances are generally safe and may assist with healthy nerve function and blood flow within the brain and inner ears.

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