Deezar Raval Physiotherapy

🌀 What is BPPV? 🌀

Benign Paroxysmal Positional Vertigo (BPPV) might sound complex, but it is one of the most common peripheral (inner ear) vestibular dysfunctions.

Here's a breakdown of what's happening:

👂 Inner Ear: Inside your inner ear, there's a structure called the utricle (part of the otolith).

It's responsible for housing tiny calcium carbonate crystals which are essentially what allow you to perceive gravity and stay upright.

Usually, these crystals stay put, minding their own business.

🔄 Semi-circular Canals: You also have a set of 3 semicircular canals in each inner ear. These canals are filled with fluid and sensors that allow you to know the direction and speed of your head movements.

💥 BPPV Unleashed: In BPPV, the crystals in the utricle come lose and basically decide to go on an adventure. They slip into one of the semicircular canals, and that's where the trouble starts. These rogue crystals move through the canal when you are in a position gravity can act on them, which triggers sensors and tricks your brain into thinking your head is spinning/moving.

😵 Vertigo Strikes: The result? Vertigo – that feeling like you or the world is spinning/moving when it is not.

BPPV will cause short episodes of vertigo, usually lasting only 10-30 seconds (but sometimes up to a minute). These dizzy spells usually happen when you make specific head movements, like bending forward, getting in/out of bed, looking up, or rolling over in bed.

🚶‍♂️ Managing BPPV: While BPPV itself is not doing damage to your inner ear, it can be distressing and increase the risk of falls. It might even throw off your balance between episodes. The good news? BPPV is highly treatable, and a skilled vestibular therapist can help you get back on steady ground.

[Disclaimer: Always consult a healthcare professional for accurate diagnosis and treatment.]

Furman JM. Patient education: Vertigo (Beyond the Basics). In: UptoDate, Post, TW (Ed), UptoDate, Waltham, MA , 2023.

🌀 Vestibular Migraines🧠

Vestibular Migraine is a neurological disorder characterized by recurring episodes of vertigo or dizziness that are usually associated with migraines.

Vertigo is the sensation of spinning or motion when there is no actual movement. In vestibular migraines, this vertigo often presents as a "to-and-fro" sensation.

Vestibular Migraines are not always accompanied by concurrent headaches, which can make the diagnosis a bit tricky; an in-depth history and multi-specialty evaluation are pivotal to make the correct diagnosis.

Key points about vestibular migraines:

🩺Diagnostic Criteria: Vestibular migraines are diagnosed based on specific criteria, including the presence of recurrent episodes of moderate to severe vestibular symptoms (like vertigo) lasting from 5 minutes to 72 hours, a history of migraines with or without aura, and the occurrence of certain migraine features during vestibular episodes.

😵‍💫Complex Diagnosis: Diagnosing vestibular migraines can be complex because the symptoms can mimic other vestibular disorders. A thorough medical evaluation and history-taking are essential for accurate diagnosis.

⚖️Treatment: Treatment for vestibular migraines often involves a combination of strategies. This may include lifestyle modifications, such as identifying and controlling triggers, as well as medications to manage symptoms and reduce the frequency of future episodes.

A vestibular therapist may help you with recalibrating your balance system after an episode and find ways to get active again! (Regular light to moderate physical activity between migraine episodes may also help decrease their frequency and intensity)

Interprofessional Care: Managing vestibular migraines may require collaboration among healthcare professionals, including neurologists, otolaryngologists, and physical therapists. A comprehensive, interprofessional approach can help improve patient outcomes.

Migraine 💪