What is BPPV?

What is BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. It is a common type of vertigo or dizziness that is caused by problems in the inner ear.

BPPV occurs when small calcium crystals (called otoliths) that are typically embedded in a gel-like substance in the inner ear become dislodged and move into one of the ear’s semi-circular canals. The semi-circular canals are responsible for detecting the movement of the head and sending signals to the brain about balance and spatial orientation.

When the otoliths become dislodged and move into the semi-circular canals, they can cause the inner ear to send false signals to the brain about the head’s position, resulting in feelings of vertigo, spinning, and loss of balance.

BPPV typically lasts only a few seconds to a few minutes, but it can be very distressing and interfere with daily activities. Treatment for BPPV typically involves a series of specific head and body movements (called the Epley manoeuvre) that can help to reposition the otoliths and alleviate symptoms.

The Hallpike-Dix Manoeuvre

The Hallpike-Dix manoeuvre is a diagnostic test used to diagnose BPPV (Benign Paroxysmal Positional Vertigo). It involves moving the patient’s head and body in specific positions to see if it causes vertigo or dizziness, which can indicate the presence of BPPV.

The Hallpike-Dix manoeuvre involves the following steps:

  1. The patient sits on a bed or table with their legs straight out in front of them and their head turned 45 degrees to one side.
  2. The healthcare provider quickly lays the patient down on their back with their head hanging off the edge of the bed or table and their neck extended.
  3. The provider holds the patient’s head in this position for about 30 seconds.
  4. The provider then raises the patient back up to a sitting position.
  5. The manoeuvre may be repeated on the other side if necessary.

During the Hallpike-Dix manoeuvre, the healthcare provider will observe the patient for symptoms of vertigo or dizziness, such as nystagmus (involuntary eye movements) or spinning sensations. If these symptoms are present, it may indicate that the patient has BPPV.

The Hallpike-Dix manoeuvre is a safe and non-invasive diagnostic test for BPPV. Still, it should only be performed by a trained healthcare physician trained in the procedure. It should not be performed on patients with neck or spine injuries or other medical conditions that make the manoeuvre unsafe.

Epsley Manoeuvre

The Epley manoeuvre is a series of specific head and body movements used to treat BPPV (Benign Paroxysmal Positional Vertigo). The Epley manoeuvre aims to reposition the small calcium crystals (otoliths) that have become dislodged and are causing vertigo.

A trained healthcare physician typically performs the Epley manoeuvre, but patients can also be taught to perform at home.

The manoeuvre involves the following steps:

  1. The patient sits upright on a bed or table with their legs hanging off the edge.
  2. The healthcare provider rotates the patient’s head 45 degrees towards the affected ear.
  3. The provider quickly lays the patient down on their back with their head hanging off the edge of the bed or table and waits for 30 seconds.
  4. The provider then turns the patient’s head 90 degrees to the opposite side without lifting the head off the bed and waits for 30 seconds.
  5. The provider then rolls the patient onto their side, with the affected ear facing down, and waits for 30 seconds.
  6. The patient is then helped back up to a sitting position.

The Epley manoeuvre may need to be repeated several times, depending on the severity of the BPPV and the patient’s response to the treatment. The manoeuvre can be very effective in relieving symptoms of BPPV. Still, it is essential to have a trained healthcare physician guide the patient through the process to ensure it is done correctly and safely.

Brandt Daroff Exercises

Brandt-Daroff exercises are a type of exercise therapy that can be used to treat BPPV (Benign Paroxysmal Positional Vertigo). These exercises are typically used when the Epley manoeuvre or other positional manoeuvres are ineffective or when patients cannot tolerate these manoeuvres.

The Brandt-Daroff exercises involve a series of movements that can help to reposition the small calcium crystals (otoliths) that have become dislodged in the inner ear and are causing vertigo associated with BPPV. The exercises are typically performed in sets of repetitions, several times per day, over several weeks.

To perform the Brandt-Daroff exercises, follow these steps:

  1. Sit on a bed or table with your feet hanging off the edge.
  2. Turn your head 45 degrees to the right.
  3. Quickly lie down on your left side with your head on the bed or table and your neck extended.
  4. Stay in this position for 30 seconds or until vertigo subsides.
  5. Sit up quickly and return to the starting position.
  6. Repeat the same movements on the other side (turn your head 45 degrees to the left and lie down on your right side).
  7. Repeat this cycle of movements (right, left, right, left) five times in a row, several times per day.

The Brandt-Daroff exercises can effectively treat BPPV, but it is essential to have a trained healthcare physician guide the patient through the process to ensure it is done correctly and safely. The exercises may only be appropriate for some patients, and should only be done under the guidance of a healthcare provider.

Our BPPV trained Physician

Dean Dickinson is our trained BPPV physician in treating BPPV at our clinics across West Sussex. Initial Consultations and first treatments are charged at £75.

Please call the clinic reception for an appointment on 01903 212999 (Worthing) or 01903 212321 (Upper Beeding/Steyning).

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