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Senior Citizen's Guide to Cleveland

Do I Have Rocks in My Head?

“When I get out of bed I have to sit on the edge and wait a few minutes for the vertigo (dizziness) to go away.” Or, “when I roll over in bed, the room begins to spin.” These are two common symptoms of a vertigo condition called Benign Paroxysmal Positional Vertigo (BPPV). In fact, according to the Vestibular Disorder Association, about 50% of dizziness in older people is due to BPPV.

What is vertigo?

Vertigo is a symptom that is the perception of spinning. Either the room spins or the sensation that there is spinning in the head. Frequently, nausea and lightheadedness are also associated with vertigo. Vertigo not only increases the risk of falls that can lead to other complications, but also may be a symptom of a more serious condition. It is important to inform your medical provider if symptoms of vertigo are experienced.

What is Benign Paroxysmal Positional Vertigo (BPPV)?

This condition is the result of dislodged calcium crystals “rocks” that move around in the semicircular canals within the vestibular system (inner ear). When the head moves in certain positions, the calcium crystals move and trigger a delayed vertigo response that can last for several seconds. Once settled, the vertigo symptoms are eliminated until the head moves resulting in the movement of the crystals once again. As the name implies, the semicircular canals are shaped like a half circle or the letter “C” in the alphabet.

What causes BPPV?

It is not always clear why this occurs; sometimes it is from a bump on the head, other times it appears after an illness or it can occur spontaneously without a known cause. When the crystals become dislodged, they sometimes migrate to the vestibule (the common area in the vestibular system where the semicircular canals are attached) where they will dissolve and there is no more vertigo. Occasionally, however, the crystals do not migrate to the vestibule but remain in the semicircular canal(s). When this occurs, treatment is necessary. Treatment for BPPV, when properly diagnosed, has an 80% cure rate and is often performed in the office.

How is BPPV diagnosed?

When the calcium crystals are loose in the semicircular canal(s), they will move in response to quick head and body movements causing vertigo. Accompanying the vertigo is an unusual eye movement (eyes jumping up and down) that can be observed. This is called nystagmus.

How is BPPV treated?

Once diagnosed, treatment can be almost immediate and successful in most cases. The patient is placed into various head and body positions that should clear the crystals from the semicircular canal(s). The treated is typically done in the office and lasts about 15 minutes. Occasionally, additional treatments are necessary that may include home exercises and/or an individualized therapy. Medical professionals treating BPPV will recommend the appropriate treatment plan.

BPPV can occur at any age and is not gender specific. Primary care physicians, otolaryngologists, audiologists and physical therapists are a few of the professionals who have knowledge about this condition. BPPV is uncomfortable and debilitating and yet is a very treatable condition. Many people who have been diagnosed and treated for BPPV regret not discussing it with their medical provider sooner in order to obtain relief.

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