Standing up too quickly, spinning around in an office chair one too many times, becoming overheated – there are many potential causes behind feeling the room is spinning. One of the most common is a condition known as benign paroxysmal positional vertigo, or BPPV. The condition usually isn’t life threatening or serious, but can certainly be a major inconvenience for those dealing with it.
An Inner Ear Problem
BPPV is ultimately an inner ear issue. It can cause dizzy spells, depending on how your head is positioned. Usually, it affects people when they are lying down, turning over in bed, or looking up.
Your ear contains a substance called otoconia, which are calcium carbonate crystals. These crystals are supposed to be attached to the utricle, which is a part of your inner ear. Occasionally, these break loose from the utricle and wind up in one of the patient’s ear canals. Once they’re in the canal, they can interfere with some of the very sensitive nerve endings in the inner ear, irritating them when the patient moves his or her head a specific way and causing the feeling of dizziness. These crystals can come loose after a head injury, following ear surgery, due to inner ear issues, or conditions like Meniere’s disease. Other symptoms such as nausea, light-headedness, or feeling off balance might present themselves as well.
Neck Manipulations Offer Relief
While BPPV is frustrating and inconvenient, it can typically be treated easily and without medication. The most common way to treat benign paroxysmal positional vertigo is through a series of neck manipulations, usually carried out by a physician, called the Epley maneuver. This process involves moving the neck and head in four specific positions in a specific order. Each position is held for between 30 seconds to one minute, and is designed to help the carbonate crystals move back through the ear canal and out to the utricle, where they’re supposed to be. If the Epley maneuver doesn’t work, there’s a similar method called the Semont maneuver. The Semont maneuver is one the patient does and involves rapidly moving the body from one side to the other while lying down. This often helps move the otoconia through the ear canal.
Don’t Ignore Dizziness
If you feel dizzy, there’s a good chance it isn’t life threatening, like BPPV, but it can be a symptom of serious medical conditions like a heart attack or stroke. If you feel dizzy, and it’s lasting longer than a few seconds, have someone take you to the doctor. Your doctor will likely do a few tests and ask some questions to determine if what you’re experiencing is BPPV. If it is, they will probably show you the proper way to carry out the Epley or Semont maneuvers and might potentially recommend medications if you’re experiencing nausea as a result of the vertigo.
Don’t attempt to drive. If you’re home alone, call 911 and have someone from emergency medical services check you out. If necessary, they’ll transport you to a hospital.
After your BPPV goes away, try sleeping with two pillows instead of one. You should also avoid sleeping on the affected side and not turning your head too far up or down. If you’re still having trouble, a neck pillow that encircles the back and sides of your neck might help you keep your neck in a more stable position. A physician may have other recommendations you should follow.
Dr. Prasad is a board-certified Ear, Nose, and Throat specialist at Kelsey-Seybold’s Fort Bend Medical and Diagnostic Center. His clinical interests include snoring, sleep apnea, dizziness, allergy/sinus disorders, hearing problems, thyroid disorders, and salivary disorders.