It is characterized by sudden spinning sensations, where the patient feels as if the world around them is spinning or moving even if they are perfectly still.
Patients often feel disoriented, off-balance, nauseous, & also experience symptoms of motion sickness when suffering from BPPV.
BPPV affects about 80% of all Vertigo patients, & is also quite easy to treat once diagnosed properly.
BPPV Causes:
BPPV causes range across a variety of medical conditions. Usually, BPPV is caused by inner ear infections & problems that make it difficult for the vestibular system to send & receive balance-related signals from the brain.
The body’s vestibular system is made up of the eyes, the ears, & the brain. These three have to work in absolute harmony for the body to be properly balanced at any given time.
When the patient experiences an inner ear infection, it can give rise to BPPV symptoms.
The various inner ear conditions that can cause BPPV include:
The displacement of calcium crystals: The primary cause of BPPV is tiny calcium crystals in the middle ear getting accidentally dislodged in the semicircular canal of the inner ear, & causing problems with the detection of proper balance signals by the brain.
These calcium crystals, also called canaliths, are sensitive to motion, & help the brain detect the body’s position in space according to various motion stimulants.
When they get dislodged from their original position & get deposited inside the semicircular canal, they cause confusion between the body’s actual position & the motion stimulants perceived by the brain due to the misplaced crystals.
This confusion is what causes dizziness, nausea, & motion sickness in BPPV patients.
How it is treated:
BPPV treatment for BPPV caused by misplaced calcium crystals in the inner ear include:
Canalith Repositioning Maneuvers: Canalith repositioning maneuvers are exercises designed to help replace the misplaced calcium crystals inside the semicircular canal.
These exercises include the well-known Epley Maneuver, the Brandt-Daroff maneuver, the Semont-maneuver, & other assorted exercises.
These exercises can either be performed at home by yourself, or under the supervision of a doctor or a licensed practitioner.
They consist of easy maneuvers designed to help facilitate the movement of calcium crystals from the semicircular canal to their original location.
1. Brandt-Daroff Exercises
Brandt-Daroff exercises utilise gravity to help dislodge crystals from the semicircular canal so that they no longer pose a problem in maintaining the body’s balance.
This exercise can be performed at home in a few simple steps as given below:
Sit in the bed with your feet on the floor, then turn your head 45 degrees in the right direction.
Without changing the direction of your head, lie down on your left side on the bed. Maintain this position for about 30 seconds.
Slowly return to the starting position, & take a 30-second pause.
Now, turn your head 45 degrees in the left side, & repeat the previous steps in the right direction.
Return to the starting position & pause for 30 seconds.
Repeat this set of procedures for about five times in a single sitting.
2. Epley Maneuver
The Epley Maneuver is another popular & commonly recommended exercise for Vertigo. Most patients with Vertigo get relief from their symptoms with the Epley Maneuver.
Although the original Epley Maneuver can only be performed with the help of at least two other people, the modified Epley Maneuver can be easily performed by yourself at home.
Below is the procedure for performing the Epley Maneuver at home if you have left-ear BPPV. In case of right ear BPPV, just perform the steps in the opposite direction.
Sit on the bed in an upright position, while placing your legs straight ahead in front of you with a pillow behind you.
Next, turn your head 45 degrees to the left.
Lie on your back quickly until your shoulders are on the bed. Hold this position for 30 seconds.
Next, turn your head 90 degrees to the left without lifting it up. Hold this position for 30 seconds.
Now, turn your body & head another 90 degrees to the right & hold for 30 seconds.
Next, sit upright on the right edge of the bed.
3. Semont Maneuver
The Semont Maneuver, also known as the liberatory manoeuvre, is another exercise for Vertigo recommended for BPPV treatment. It takes less time to perform than the Brandt-Daroff exercise; however, these should best be done in the presence of a healthcare provider.
For the below set of exercises, we’ll assume that you have left-ear BPPV.
Sit on the edge of your bed in an upright position & turn your head 45 degrees to the right.
Quickly drop to your left until your head is on the bed, & hold this position for 30 seconds.
Next, quickly move your body to the right side in a single movement without changing the position of your head.
Hold this position for 30 seconds, then slowly return to the starting position.
Surgical Alternatives:
In some cases, where no other BPPV treatment options seem to be working for the patient, your doctor may recommend the canal plugging surgery to you.
This surgery involves using a bone plug to block the portion of the inner ear that is causing the problems.
This surgery is often the last resort for patients for whom no other BPPV treatment options seem to be working.
The success rate for canal plugging surgery is about 90%, & it is a safe, long-lasting alternative for desperate situations of BPPV.
Looking for effective resolution of your Vertigo symptoms & adequate Vertigo management options? Visit www.vertigoandearclinic.com for more information about Vertigo, its symptoms, vertigo treatment options, & management process.
Migraine headaches are a fairly common condition among many people today. General migraines are characterized by moderate to severe headaches, which are pounding & throbbing in nature.
Vestibular Migraines, on the other hand, are characterized by
migraine headaches along with vestibular symptoms such as nausea, vomiting,
disorientation, & dizziness.
Some of the most common Vestibular Migraine symptoms are:
●
Severe, throbbing headache that is usually
concentrated to one side,
●
Nausea & Vomiting
●
Sensitivity towards light, smell, & sounds.
Other Vestibular Migraine symptoms:
●
Vertigo, that usually lasts for a few minutes
to hours, & in certain cases, can also last for a few days,
●
Unsteadiness, disorientation, & loss of
balance,
●
Sensitivity towards motion & motion stimuli
Certain subjective hearing symptoms, such as ringing, fullness,
& pressure in one or both ears are also common, although if you suffer from
significant hearing loss, you should go for a diagnosis of Meniere’s Disease.
Vestibular Migraines often cause a person to experience a range of
vestibular symptoms such as visual aura, or sensitivity to visual stimulation
& motion at the same, or different times. These symptoms can also occur
with headaches, or without.
Vestibular Migraine causes:
Most cases of Vestibular Migraine are hereditary. That said, women
are also more likely to suffer from Vestibular Migraine. For women, Vestibular
Migraine symptoms also tend to worsen at the time of menstruation.
Additionally, people with Vestibular Migraine experience the
following disturbances after their migraine episodes; altered sleep patterns,
MSG, disturbances in menstrual cycles, etc.
Vestibular Migraine Diagnosis:
Since a vast majority of people with Vestibular Migraine do not
experience vestibular symptoms along with migraine headaches, it can become
difficult for doctors to diagnose them with Vestibular Migraine.
The symptoms of Vestibular Migraine can also present as other
illnesses such as:
●
Benign Paroxysmal Positional Vertigo(BPPV)
●
Meniere’s Disease
●
Transient Ischemic attack, also known as a
‘mini-stroke’
It is also quite a common occurrence for these three disorders to
exist together, thus making the diagnosis even more difficult.
Vestibular Migraine treatment:
Vestibular Migraine treatment is similar to that of general
Migraines. It includes minimizing the usage of meclizine or any other medicines
that suppress the vestibular system, using them only during an active episode.
In case the patient is experiencing recurrent, frequent attacks,
your doctor may prescribe certain medications like:
●
Beta-blockers,
●
Calcium channel blockers,
●
Tricyclic antidepressants
●
Serotonin or norepinephrine reuptake
inhibitors(SSRIs or SNRIs)
●
Topiramate
Along with these medicines, patients suffering from vestibular
migraines are also advised to maintain a regular sleep & meal schedule, get
proper sleep of 8 hours everyday, reduce their intake of alcohol &
caffeine, & avoid known migraine
triggers.
Vestibular Migraine patients are also advised to engage in
activities that reduce stress, & avoid situations that can trigger an
involuntary neurological response, such as harsh lighting, loud, shrill sounds,
& engaging in activities that produce an adrenaline rush.
To know more about Vestibular Migraine & how the condition
affects a person’s everyday life, along with more about its diagnosis, new
treatment breakthroughs, & management options, visit Dr. Anita Bhandari’s
Vertigo And Ear Clinic, here.
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Vestibular Rehabilitation therapy is an exercise-based rehabilitation program that is designed by experts to help the body deal better with Vertigo attacks & dizziness spells.
Vestibular Rehabilitation Therapies have been credited with successfully helping Vertigo patients compensate for the loss in the natural balance system of the body, & for organically reducing the intensity of Vertigo & dizziness spells experienced by the patient.
Vestibular Rehabilitation Therapies can be categorized into two primary types:
Physical Therapy for Vestibular Hypofunction,
Canalith Repositioning Therapy for Benign Paroxysmal Positional Vertigo(BPPV)
Peripheral Vestibular Hypofunction is characterized by damage to the inner ear nerve which is responsible for carrying the nervous inputs from the inner ear to the brain.
This can occur either in a single ear or both.
This can lead to dizziness, Vertigo, unsteadiness, lightheadedness, falls, & disorientation among other things.
Physical Therapy for Vestibular Hypofunction includes four different types of exercises that are performed under the guidance & supervision of experts.
These exercises are:
Gaze Stabilization Exercises: The primary goal of these exercises is to improve the patient’s vision during head movements. These also have been shown to be effective in reducing dizziness & improving unsteadiness in a patient.
This exercise is carried out under expert supervision, & involves the patients performing various head movements while maintaining their gaze on a fixed object.
Doing these exercises multiple times daily helps rehabilitate the patient’s sense of head-eye coordination & reinstate balance.
Habituation Exercises: The primary goal of these exercises is to reduce dizziness and Vertigo spells. These include the patients watching things that move rapidly, or perform certain head movements that bring about dizziness.
Once the patient performs these exercises multiple times over a length of time, these feelings of dizziness & Vertigo go away overtime, & the body learns to compensate for this loss in setting balance.
Balance & Gait Exercises: The goal of these exercises is to improve the body’s steadiness & prevent falling over while standing or moving activities.
These exercises include a variety of customized balance & posture exercises to help the body maintain a steady balance while performing certain exercises.Endurance walking or aerobic Exercises: These exercises are important as in most cases of Peripheral Vestibular Hypofunction, patients are told to avoid walking, running, or jogging to avoid the dangers of a fall or an injury due to dizziness.
These exercises involve the patients generating natural endurance & stability for walking & performing other aerobic exercises, so that overtime, their body compensates for the loss in balance automatically.
Patients who experience difficulty with their vision during certain head movements, should perform the gaze stability exercises at least three times per day, each session lasting at least 12-20 minutes.
Canalith Repositioning Maneuvers are used to treat Peripheral Vertigo arising from Benign paroxysmal Positional Vertigo(BPPV).
BPPV occurs when the calcium carbonate crystals in the inner ear mistakenly get deposited in the semicircular canal, causing problems with sending accurate balance signals to the brain causing dizziness & Vertigo.
Canalith Repositioning Maneuvers target these dislodged crystals in the semicircular canal & reinstate them to their original position in the inner ear.
Canalith Repositioning Maneuvers include well-known Vertigo exercises like the Epley Maneuver, the Semont-Foster Maneuver, the Semont-Toupet Maneuver, the half-somersault maneuver, the Brandt-Daroff exercises, among others.
Epley Maneuver:
The Epley Maneuver is a highly recommended & effective exercise for Vertigo.
To perform it, follow the below mentioned steps:
Sit on your bed, place your legs straight ahead & put a pillow behind you.
Turn your head to the left 45 degrees.
Quickly lie back placing your shoulders on the pillow, & hold for 30 seconds.
Turn your head to the right 90 degrees without lifting it up, & hold for 30 seconds.
Turn your head & body another 90 degrees to the right without lifting it up, & hold for 30 seconds.
Now, sit straight on the edge of the bed.
Perform the maneuver three times a day, repeating everyday until the symptoms cease.
These steps are for when you have left-ear BPPV. In case of right ear BPPV, perform these steps on the opposite side.
Semont Maneuver:
The Semont Maneuver is also called the liberatory maneuver, & is another highly recommended Vertigo exercise.
To perform this maneuver, your doctor will make you follow the below mentioned steps:
Sit on the edge of your bed & turn your head 45 degrees to the right.
Quickly drop to your left side until your head is on the bed, & hold for at least 30 seconds.
Now move your body to the right side in one movement, without changing the angle of your head.
Hold this position for about 30 seconds, & slowly return to your original position.
In case you have right-ear BPPV, turn your head in the right direction & start on your left side.
This maneuver should provide relief after performing only once.
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Benign Paroxysmal Positional Vertigo, BPPV, as it is more commonly known, is a specific type of Vertigo that causes sensations of spinning, & dizziness to patients. BPPV is the most common type of Vertigo that patients suffer from.
Infact, you can get a gist of the disorder by its name only.
Benign, means that it is not a very serious condition, i.e., there is no immediate danger to your life.
Paroxysmal, means that its attacks & episodes are sudden in nature, last for short durations, & keep recurring for certain periods.
Positional, means that the episodes are triggered by certain changes in position, head movements, & sudden changes in the body’s position.
Vertigo, signifies that the disorder is a type of Vertigo, & is characterized by bouts of dizziness, nausea, & loss of balance.
Benign Paroxysmal Positional Vertigo(BPPV) is quite common in adults, & is usually easily treatable in doctor’s offices.
BPPV, as is evident in its definition, isn’t a serious condition, & isn’t fatal unless frequent bouts of dizziness cause you to fall while standing, climbing, running, or driving.
If the attacks occur way too frequently, then it may be caused by some other underlying illness or cause. It’s important for you to sit with your doctor & have them give you an accurate diagnosis of your condition, in order to formulate a better treatment plan.
Benign Paroxysmal Positional Vertigo(BPPV) symptoms:
A sensation that your surroundings are spinning,
Nausea
Vomiting
Lightheadedness
Dizziness
Unsteadiness
Loss of balance & sense of coordination while walking, standings, sitting, etc.
Sometimes, patients with BPPV also experience varying intensities of migraines.
There is a very easy test to determine which ear of yours is the cause of your BPPV symptoms, before you even make your first official visit to the Vertigo specialist.
Sit on the edge of your bed such that your head hangs over the edge when you lie down.
Turn your head to the right now, & lie down quickly.
Now, wait for about 1 minute. If you feel dizzy, then that means that the right ear is affected & is causing your BPPV symptoms.
If you don’t experience any dizziness during the above steps, then repeat the steps in the left direction. If you do feel dizziness then, then that would mean that the left side of your ear is affected.
We all have tiny calcium carbonate crystals, also called otoconia, inside our ears. Sometimes, these crystals can get dislodged from their original position & get deposited in the inner ear canal. The inner ear canal is an integral part of our body’s balance system, & is responsible for transporting balance signals from the inner ear to the brain.
When the crystals get deposited there & form lumps, they hinder the path of the balance signal carrying nerves, thus creating a discrepancy between the balance perception & the actual situation in the surroundings.
This disorientation is what causes the dizziness & the spinning sensation associated with BPPV Vertigo.
Any kind of head injury, viral infections like viral labyrinthitis, Meniere’s Disease, can cause these crystals to move from their original position. Sometimes, the movement occurs naturally, & there is no known cause for it.
BPPV Treatments
Benign paroxysmal Positional Vertigo(BPPV) is a highly common disorder, & is also very easily treatable. It is important to note here however, that some cases of BPPV might not be treatable at all. In such cases, the patients usually have to live with BPPV for their entire lives, albeit with strong management techniques.
There are certain maneuvers & exercises that BPPV patients can do at their homes, to treat & better manage their BPPV.
Some of these are mentioned below:
Epley Maneuver
The Semont-Toupet Maneuver
Canalith Repositioning
These exercises can either be done along with or under the supervision of, your healthcare provider &/or Vertigo specialists. However, some of these can also be done alone at home without any specialist supervision.
In some cases, where none of the above mentioned exercises & maneuvers show tangible results, surgery might be an option for BPPV patients. Your doctor will tell you if surgery is the right way forward for you, based on an accurate diagnosis & your medical history.
Working with Vertigo & dizziness specialists is the first step towards treating & managing your Vertigo. Get in touch with expert Vertigo specialists, only at Vertigo And Ear Clinic.
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Sudden hearing loss need not always be sudden, however, & can also occur gradually, until the hearing is completely lost in one or both the ears.
Sudden hearing loss should be considered a medical emergency, needing immediate attention of experts & specialists.
Most times, people who develop sudden hearing loss hesitate to go to the doctor as they believe it will clear up on its own time. However, this is a dangerous assumption to make & the more you delay your visit to the doctor, the less the treatments of sudden hearing loss will be effective.
Most people who develop sudden hearing loss, do so in only one ear. Rarely enough, however, sudden hearing loss in both the ears is also seen.
Diagnosis of Sudden Hearing Loss
Sudden hearing loss is diagnosed using a standard hearing test called Pure Tone Audiometry. This test determines if the hearing loss is caused by an obstruction in the path of sound waves like inner ear fluid, ear wax, tumours, etc., or if it is caused by neurological issues. This test can also determine the amount of hearing loss in decibels.
If the test logs a loss of at least 30 decibels in three connected frequencies, then the patient is diagnosed as suffering from Sudden Hearing Loss.
To make it clear for the layman reader to understand, a loss of 30 decibels in hearing frequency will make conversations on a regular pitch sound more like a whisper.
Most people with sudden hearing loss notice the loss of hearing when they wake up in the morning one day.
Some others, however, discover their hearing loss when they try to use the deafened ear while talking on phones or any other thing.
Some people with sudden hearing loss also report hearing a loud ‘pop’ like sound just before they notice their hearing loss.
Often, people who report to hospitals with sudden hearing loss also complain of feeling dizzy & a loud ringing noise in their ears also called tinnitus.
This happens as a result of the neurological disturbances in the balance centre that is located in the inner ear. When a person experiences sudden hearing loss, their balance centre also gets disoriented, thus leading to sensations of spinning, a loss of balance, & feelings of dizziness.
Causes of Sudden Hearing Loss
In most cases of Sudden hearing loss, close to approximately 85%, there is no proper identifiable cause. Only about 10-15% of patients with sudden hearing loss have a known cause.
These known causes of sudden hearing loss include:
Certain infectious diseases that affect the inner ear
Trauma from a head injury
Autoimmune diseases like Cogan’s syndrome
Taking an overdose of ototoxic drugs, which are drugs that harm the sensory nerves in the inner ear
Blood circulation issues
A tumour on the nerve connecting the ear to the brain
Certain neurological disorders like Multiple Sclerosis, and
Inner ear diseases like Meniere’s Disease
Treatment of Sudden Hearing Loss
The most common treatment of sudden hearing loss, especially in cases where the cause of the hearing loss is unexplainable, is corticosteroids.
Steroids are commonly used by medical practitioners to treat various types of disease & disorders.
Steroids help by reducing inflammation in the body, decreasing swelling, & aiding the body’s immune system to fight back in most cases of viral infections.
While steroids are usually prescribed in the form of a pill, direct injection based steroids therapy called intratympanic corticosteroid therapy, has also become popular in recent years.
In this, the corticosteroids are injected in liquid format behind the eardrum into the middle ear, where they travel into the inner ear & reduce any inflammation.
Intratympanic corticosteroid therapy may also be beneficial for patients who are otherwise unable to take oral steroids.
Depending on your exact diagnosis, your doctor will prescribe an adequate treatment plan that can help restore the sudden hearing loss.
Trusting the right specialists & experts with your condition is the first step to take in order to help restore your sudden hearing loss. At Vertigo and Ear Clinic, we have a dedicated team of Vertigo & ear specialists that accurately diagnose, treat, & manage your conditions.
We utilize a slew of innovative technology, experience, & expertise to help make each of our patients’ lives better.
Learn more about the treatment of sudden hearing loss here.
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