If you feel dizzy when if you move your head up or down or sideways, or
when you turn in bed or while getting in and out of bed you could be a
victim of BPPV (Benign Paroxysmal Positional Vertigo). This condition is
unfortunately not so well known and not always diagnosed correctly
The incidence of BPPV is on the rise. Says Dr OP Kapoor, distinguished
physician and author, "Many family physicians and even some specialists may
not be aware that the commonest cause of repeated attacks of this particular
kind of vertigo (dizziness) is BPPV. BPPV is often mistaken for Meniere's
disease, which is a more serious ear condition."
So what exactly is this BPPV? BPPV stand for benign - not harmful;
paroxysmal - periodically; positional - brought on by certain positions and
vertigo - giddiness. The problem of misdiagnosis can arise if the patient is
unable to explain to the doctor the kind of vertigo he is experiencing. All
feelings of nausea, lightheadness or lack of balance are often clubbed
together under one heading: giddiness or vertigo. However the vertigo
experienced by BPPV sufferers is distinctively different. "The feeling that
everything around you is moving or rotating and when this is brought on by
movement of the head, it is usually a symptom of BPPV," says Dr DM Borkar,
ENT specialist, Breach Candy Hospital.
This diagnosis can be confirmed with a test called the Hallpike Test. It's a
simple enough test (but to be performed by a trained professional) and
involves the patient being made to lie down in a particular position and his
head abruptly turned by skilled hands. If vertigo is induced, it is a
confirmation that the patient has a case of BPPV. "The Hallpike test has
been in use for very many years now and though it sounds simple, it should
be done only by a trained ENT specialist," says Dr Borkar, who holds
workshops to spread awareness of this disease amongst general practitioners.
As many as 30 per cent of vertigo sufferers suffer from BPPV but they are
usually unaware that the problem lies with the ear and thus often approach
general practitioners.
The root cause of BPPV lies in the ear, the ear being one of the vital
organs which helps us maintain our balance. "We keep our balance due to
combined efforts of our ears, eyes, the cervical spine (neck) and the brain,
but BPPV specifically is caused because of a problem in the inner ear," says
Dr Tushar V Mhapankar, ENT specialist.
What actually happens inside a BPPV sufferer's ears? In layman's terms,
certain particles shift from a tiny space in the ear called the utricle into
the semicircular canals of the inner ear. "If these particles become loose
and move from their proper place inside the ear, BPPV can be brought on,"
says Dr Borkar. When thus displaced, these particles provoke the sensations
of rotation and movement following changes in head position.
And therein lies the cure. An attempt is made to shift the particles by
sequential movements of the head into various positions. "The particles need
to be put back in their proper place and if this is done successfully, the
patient feels better," says Dr Borkar. This procedure called Epley's
procedure can be done by a specialist. Best of all, it involves no surgery!
Known in India for over a decade, it's success rate is high, confirms Dr
Borkar. In case BPPV reoccurs as in some instances, a second treatment can
be carried out. The doctor might even suggest some exercises to the patient
that can be performed at home.
So, if you think you might have BPPV or suspect that someone you know has
it, don't prolong the agony by spending precious time or money on expensive
diagnostic tests - visit an ENT who is familiar with the Hallpike Test and
Epley's procedure.
Although BPPV is not a new or modern disease, the test and cure for BPPV are
comparatively new, so make sure you find the right doctor.
Felt like this? The problem of misdiagnosis can arise if the patient is
unable to explain to the doctor the kind of vertigo he is experiencing. All
feelings of nausea, lightheadness or lack of balance are often clubbed
together under one heading: giddiness or vertigo. However the vertigo
experienced by BPPV sufferers is distinctively different.
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