Benign Paroxysmal Positional Vertigo Treatment Brisbane

Common Causes

Some known common causes of Benign Paroxysmal Positional Vertigo (BPPV) include head injury, problems after ear surgery, degeneration of the vestibular system brought on by ageing and general issues within the inner ear, such as an inner ear disorder or inner ear disease (such as vestibular neuritis). These issues can dislodge calcium carbonate crystals, leading to vertigo episodes. BPPV can occur in different forms depending on the affected semicircular canal: anterior canal BPPV is triggered by tipping the head forward, while posterior canal BPPV is provoked by movements that change head position like rolling over in bed with your head turned to the side of the affected ear. Understanding what triggers vertigo attacks, their causes and specific types is crucial for accurate diagnosis and management of BPPV.

BPPV Theory

There are two main theories about the cause of BPPV. These theories both speak about abnormal detections triggering abnormal sensations of vertigo, regarding changes in the endo-lymph that flows in either the horizontal, anterior, or posterior semicircular canal of the otolith organs. The two theories are as follows:

The Cupulolithiasis Model

Suggests that loose matter in the endolymph becomes stuck in the cupula, or the sensory organs that are located in the otolith. 

The Canalithiasis Model

Suggests that the cupulas detect free-flowing particles in the endolymph.

There are two physical tests that can be used to gather an accurate BPPV diagnosis. The Dix-Hallpike Test can be used to detect dysfunction in the affected canal of the otolith, while the supine roll test can be used to assess the horizontal canal. In positive tests; the patient will experience their symptoms of vertigo (dizziness occurs), and the therapist will observe for signs of nystagmus, or rapid beating of the pupils. In the rare case that the superior semicircular canal is affected, the Dix -Hallpike test would be positive and the therapist will observe a horizontal, vertical, or rotary nystagmus.