Benign Paroxysmal Positional Vertigo is a common cause of dizziness or vertigo and is a condition of the inner ear.
Benign Paroxysmal Positional Vertigo and the Epley Manoeuvre
Benign Paroxysmal Positional Vertigo is a common cause of dizziness or vertigo and is a condition of the inner ear. It can occur in people of all ages but is more common in middle age, and the later years of life.
- Benign- means that the underlying cause is not serious and although the symptoms can be most unpleasant.
- Paroxysmal- the dizziness often comes in short bursts and can keep occurring suddenly.
- Positional – can be triggered by the head or body being in certain positions.
- Vertigo -a spinning sensation together with dizziness. This can make you feel as if the world is spinning around you, and you feel very unsteady, together with a feeling of, or actually being sick.
Benign Paroxysmal Positional Vertigo (BPPV) is thought to be caused by one or more of the tiny solid fragments of calcium carbonate crystals (otoconia) that float about in the fluid of the labyrinth in the ear. Symptoms of vertigo can occur if otoconia get into one of the semicircular canals – usually the posterior canal.
When your head is still, the otoconia sit at the bottom of the posterior canal, but on moving the head in certain directions, the otoconia gets carried along with the flow of fluid.
Most cases of Benign Paroxysmal Positional Vertigo occur in people over the age of 40. However, some younger people can develop BPPV following an injury to the ear, or following a previous infection in the inner ear.
The main symptom is intense dizziness or vertigo and lasts typically from a few seconds too often no more than a minute, and then goes away completely. Two of the most common movements that trigger the symptoms can be rolling or getting out of bed, but just looking up can also cause it.
The Epley Manoeuvre
This procedure is used by GP’s and Consultants, and also other healthcare professionals like chiropractors, and can be extremely effective where otoconia are at the bottom of your posterior semicircular canal, rather than where they should be, in the vestibule of the inner ear.
As dizziness can be caused by a number of different things, the chiropractors would not perform the Epley Manoeuvre without a full initial consultation. This would also include checking your blood pressure, associated neurological and orthopaedic tests, and a full chiropractic assessment, to ensure it is safe and appropriate for you to receive any form of treatment.
To gain the most from treatment, and to allow the otoconia to settle in their new situation in the vestibule, and to reduce the risk of their falling back into the posterior semicircular canal:
- Do not lie flat for 48 hours.
- During this time sleep sitting in a chair.
- Do not lie on the affected side for at least one week.
- Ideally, try to avoid bending over (such as to tie shoelaces) for a week.
Some studies have shown that the Epley manoeuvre is successful in stopping symptoms in 8 in 10 cases, with just one treatment. If the first treatment is not fully successful, research has shown that a repeated treatment session a week or so later can be effective and if symptoms return at a later date, the manoeuvre can be repeated again.
Keeping safe with benign paroxysmal positional vertigo.
It is important to know that the DVLA recommends that you should stop driving if you get sudden, unexpected and disabling attacks of dizziness.
You must tell your employer that you have vertigo if your dizziness could possibly pose a risk to yourself, or to others. This is important if your job includes (but is not limited to) using ladders, operating heavy machinery, or if you drive any form of vehicle in any capacity for your job.
You can try and reduce the attacks by getting out of bed slowly, and avoid jobs around the house that involve looking upwards, like painting a ceiling.
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