Feeling dizzy? You might have BPPV.
If you feel dizzy when if you move your head up or down or sideways, or when you turn in bed or while getting in and out of bed you could be suffering from BPPV (Benign Paroxysmal Positional Vertigo) a disease not so well known and not always diagnosed correctly.
Unfortunately, this disease is very common. Says Dr. O.P. Kapoor, distinguished physician and author, ‘Many family physicians and even some specialists may not be aware that the commonest cause of repeated attacks of this particular kind of vertigo (dizziness) are due to BPPV. BPPV is often mistaken for Meniere’s disease, which is a more serious ear condition.’
So what exactly is this BPPV? As the name itself suggests, it is a one of nature’s benign diseases. BPPV. Benign – not harmful. Paroxysmal – periodically. Positional – brought on by certain positions. Vertigo – giddiness.
The problem of misdiagnosis can arise if the patient is unable to explain to the doctor the kind of vertigo he is experiencing. All feelings of nausea, lightheadness or a lack of balance are often clubbed together under one heading: Giddiness or Vertigo. However the vertigo experienced by BPPV sufferers is distinctively different. ‘The feeling that everything around you is moving or rotating and when this is brought on by movement of the head it is usually a symptom of BPPV,’ says Dr. D.M Borkar, ENT Specialist, who consults with Breach Candy Hospital.
Ofcourse a test must finally determine whether the patient is actually suffering from BPPV, and there is specific one for this purpose, called the Hallpike Test. It’s a simple enough test (but to be performed by a trained professional) and involves the patient being made to lie down in a particular position and his head abruptly turned by skilled hands. If vertigo is induced, it is a confirmation that the patient has a case of BPPV. ‘The Hallpike test has been in use for very many years now and though it sounds simple, it should be done only by a trained ENT specialist,’ says Dr. Borkar, who holds workshops to spread awareness of this disease amongst general practitioners. As many as 30 per cent of vertigo sufferers suffer from BPPV but they are usually unaware that the problem lies with the ear and thus often approach GP’s.
The root cause of BPPV lies in the ear, the ear being one of the vital organs which helps us maintain our balance. ‘We keep our balance due to a combined efforts of our ears, eyes, the cervical spine (neck) and the brain, but BPPV specifically is caused because of a problem in the inner ear,’ says Dr. Tushar.V.Mhapankar, ENT specialist.
What actually happens inside a BPPV sufferer’s ears? In layman’s terms, certain particles shift from a tiny space in the ear called the utricle into the semicircular canals of the inner ear. ‘If these particles become loose and move from their proper place inside the ear, BPPV can be brought on,’ says Dr. Borkar. When thus displaced, these particles provoke the sensations of rotation and movement following changes in head position.
And therein lies the cure. An attempt is made to shift the particles by sequential movements of the head into various positions. ‘The particles need to be put back in their proper place and if this is done successfully, the patient feels better,’ says Dr. Borkar. This procedure, called Epley’s procedure is done by a specialist. Best of all, it involves no surgery! Known in India for over a decade, it’s success rate is high, confirms Dr. Borkar. In case BPPV reoccurs as in some instances, a second treatment can be carried out. The doctor might even suggest some exercises to the patient to do at home.
So, if you think you might have BPPV or suspect that someone you know has it, don’t prolong the agony by spending precious time or money on expensive diagnostic tests – visit an ENT who is familiar with the Hallpike Test and Epley’s procedure. Although BPPV is not a new or modern disease, the test and cure for BPPV are comparatively new, so make sure you find the right doctor.
(Published in The Times of India in 2006)
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