vertigo & Benign Paroxysmal positional vertigo (BPPV) (Jenna)

Vertigo refers to the sensation of dizziness that can occur due to conditions of the inner ear, sensory nerve pathway, or the brain. The inner ear serves as the site for sensory stimulation of the vestibular system. Normally, this system provides information regarding movement of the body in space and balance. With vertigo, there is an abnormality in this system such that false information is provided which results in the sensation of spinning or dizziness.

BPPV is the most common cause of vertigo in the aging population. It causes dizziness or spinning with rapid positional changes such as moving/turning the head or getting up and down. BPPV gives you the feeling that the room or environment is spinning around you. 

Here is a video to help explain BPPV: http://www.granvillephysio.ca/other-conditions.html

symptoms

  • Vertigo or the sensation of spinning at rest
  • Disoriented in space 
  • Nausea or motion sickness
  • Unsteadiness/loss of balance 
  • Headaches
  • Tinnitus (ringing in the ears)
  • Blurred vision 
  • Nystagmus (involuntary side to side eye movement)

causes

  • Primary cause is idiopathic or unknown
  • secondary causes can include: 
    • Head trauma 
    • Labyrinthitis (inflammation of the inner ear labyrinth)
    • Vestibular neuritis (infection of the vestibular nerve)
    • Cholesteatoma 
    • Meniere's Disease
    • Benign Paroxysmal Positional Vertigo (BPPV)
    • Migraines 

treatment

  • Vestibular rehab
    • canalith repositioning maneuvers such as the Epley Maneuver work to move debris out of the semicircular canals to cease the disruption in  endolymph fluid flow
  • IMS/Dry needling
    • if migraines are the source of vertigo, IMS can be used to release shortened muscles that may be putting excess pressure on the nervous system and causing symptoms 
  • Therapeutical exercises
    • habituation, gaze stabilizing, and balance exercises may be prescribed depending on the nature of the vertigo (these are not suitable for BPPV). They can aid in decreasing fall risk during an episode, or reducing dizziness via repeated exposure to certain movements 
      • e.g. tandem stance with eyes closed, Brandt-Deroff exercises  

how does physiotherapy help?

During Vestibular Rehabilitation the cause of dizziness/vertigo is determined by assessing eye movements, balance, posture, aggravating movements, or visual system influences. Information such as medical conditions, medications, and prior history are taken into account for their involvement in exacerbating the condition.

You will be given a customized treatment plan consisting of manual therapy techniques within the clinic, at-home exercises, or home-care principles. During the assessment, symptoms may be exacerbated but your treating therapist will guide you through the process. 

If you are suffering from vertigo, spinning or dizziness and you are unsure of the cause, don't wait to get assessed. You will be surprised that such delicate structures of the inner ear can have such a profound effect on your quality of life.  Book today with Granville Physio's Inner Ear specialist Brendon Ip.