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Positional Vertigo

Positional Vertigo

Dizziness and lightheadedness are a frequent problem for many of us. As an Ear, Nose and Throat specialist I have often asked to evaluate people with persistent balance issues. Usually dizziness that comes from the inner ear is known as vertigo.

Vertigo is not one single disease. There are multiple conditions in the inner ear that can cause the symptom of room spinning and disorientation. Sometimes these episodes last hours and are hard to control. Some episodes are very short in duration and are just associated with a spinning sensation lasting less than 5 minutes following movement.

This particular disease process of the inner ear is called benign paroxysmal positional vertigo (often abbreviated as BPPV). As the name implies it is related to position change. For clarification, a paroxysm is a sudden severe attack of some disorder affecting the body. A person can have a paroxysm of coughing where it is difficult to catch their breath.

This type of vertigo is related to the location of microscopic crystals in the inner ear that have been dislodged or displaced to an incorrect position.  The inner ear is a very tiny, very complex structure that is responsible for both hearing and balance. Within the balance part is a tiny sac containing some of these microscopic crystals. Occasionally they get moved to another part of the inner ear which causes dizziness with head turning. The displacement may be the result of mild head trauma or often we do not know how it occurs.

The condition is called benign positional vertigo because it does not cause hearing loss. And luckily it can be treated without medications usually by doing some maneuvers to put the crystals back in the spot where that does not bother you.

The diagnosis is usually made by having my patient lay back with the head turned first to the left then to the right to see which ear causes dizziness. Once we know which ear is the source of the problem a fairly simple maneuver can be done to reposition the crystals. This was first described by a doctor Epley and the most common treatment is the Epley maneuver. A simple Internet search will show how it is done and there are even videos available on YouTube.

Hopefully none of you gets this problem but if it does occur it is something my office staff is well trained in treating.

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