BPPV is the most common of the “Big 5” of vestibular (balance/dizziness) problems. As the name suggests, BPPV is a benign (not harmful – even though unpleasant), sudden (paroxysmal), and caused by positional change.
The vestibular system has 3 canals filled with fluid and small sensory cells to detect head movement. In turn, these relay instructions to move the eyes in a perfect coordination. Thus, the environment remains visually stable regardless of direction or speed of head movement. There are also small crystals (called otoliths or otoconia) in the balance system, which help us to sense acceleration. These rest on a jelly-like pad which moves with horizontal or vertical acceleration.
Occasionally, due to various reasons, one of these crystals can loosen, fall off their jelly- pad, and land inappropriately in one of the fluid-filled balance canals. When a crystal rolls freely in a balance canal, it affects the sensory measurements, fooling them into detecting inaccurate movements of the head. This can cause intense but brief dizziness, and sometimes nausea. These episodes may need treatment, as they can lead to falls, avoidance of movement, and even some anxiety.
Fortunately, an audiologist who works with dizziness can easily diagnose this condition with a specific manoeuvre. We use a series of specifically targeted movements to reposition the crystal – moving it successfully OUT of the fluid canal, and back to the jelly-pad where it belongs. This should be done with a balance professional, as it is important to know which of the six canals is involved, to help effectively. Treatment is usually highly effective and successful, if done properly.