Vertigo is the sensation you feel when you or the environment around you spins, making it difficult for you to keep balance. Benign postural vertigo is one of the most commonly caused vertigo, which leads to brief periods of mild or intense dizziness. Vertigo can have many origins, but a visit to a qualified ear, nose, throat physician will help to rule out if you are a victim of benign paroxysmal postural vertigo. The ENT Clinic is a great medical practice located in Singapore with experienced ENT specialists to visit if you are having vertigo trouble. The qualified and dedicated ENT surgeons are able to identify the cause behind your vertigo and put a full stop to it.
What is benign paroxysmal postural vertigo?
BPPV is a sudden sensation of spinning inside your head and it is generally triggered by the specific changes in the head’s position. The intensity of dizziness can vary from being mild to intense and may occur when you lower or raise your head suddenly or when you lie down or turn your head around, to sit up. Sudden changes in your posture can cause this dizziness and it is best reviewed by an ENT doctor as elderly can have falls with the dizziness.
What are the signs and symptoms of paroxysmal positional vertigo?
The signs which are generally observed include
- Dizziness
- Moving or spinning of the surroundings
- Loss of balance
- Vomiting
- Nausea
- Light-headedness
- Blurred vision
These symptoms can fluctuate in less than a minute and then recur depending on the severity of the condition. The kind of activities which can trigger this condition, can vary from one person to another, but it is always due to head movement. It is not uncommon for individuals to go through this condition when they walk and feel loss of balance. The symptoms are generally accompanied with abnormal rhythmic eye movements.
What are the causes of benign positional vertigo?
This condition is caused due to a disturbance in the inner ear. There are semicircular canals present in the inner ear which are filled with fluid. These semicircular canals are very sensitive and when there are movements, it causes the fluid in the semicircular canals to move. When one has BPV, the calcium carbonate crystals which are present in the ear, break free and enter these semicircular canals. This makes our brain to receive messages which are confusing about the position at which the body is at that time.
Who has a higher risk of developing BPV?
It has been observed that genetics can play a role. Patients suffering from this condition had relatives who had this condition too. Some of the other factors which can lead to developing benign postural vertigo include head trauma, diabetes, inner ear disorders and osteoporosis. Complication from BPV is rare, but there is a higher tendency for falls and accidents.
How is BPPV diagnosed by your ENT doctor?
To diagnose this condition, your doctor will do a physical examination and take a detailed medical history to understand the frequency and severity of the condition. It is important for the ENT doctor to understand the head movements which lead to this condition and thus, the ENT doctor will perform a manoeuvre called the Dix-Hall pike test. The specialist doctor will tilt the head in different positions while you lie flat on a bed and also observe abnormal eye movements and question if you experience a spinning sensation. If your doctor cannot find the condition this way, then he will order additional tests and also perform a neurologic examination to rule out other conditions.
The other tests which are generally performed include:
- Electronystagmography (ENG) or videonystagmography (VNG): These tests help to detect abnormal eye movement. This test can help to determine if the dizziness is caused by an inner ear problem. As part of the test, it measures the involuntary eye movements when the head is at different positions.
- Magnetic resonance imaging: An MRI scan can detect magnetic field and radio waves to create cross-sectional images of the head and body. This will also help to rule out any other reasons for vertigo.
- EEG: To measure brain activity
- Caloric stimulation: It’s a way to observe eye movements by warming and cooling the inner ear.
- Hearing Evaluation
What are the treatment options for benign postural vertigo?
This condition may go away on its own after a few weeks or months, however, if it is persistent then treatment should be sought. Some of the treatment options include:
- Canalith Repositioning – It is a manoeuvring process done by the ENT doctor to reposition the calcium crystals back into the vestibule from the semicircular canals. The ENT doctor slowly repositions the head several times and moves the crystals out from the fluid filled semicircular canals. The doctor positions the head at one place for 30 seconds. With a few sessions, the condition is usually relieved.
- Medication: An ENT doctor may prescribe medications to relieve the dizziness and it can include sedative hypnotics, anticholinergics and antihistamines.
Surgical intervention: If your ENT physician feels that canalith repositioning isn’t working, then the doctor may suggest a surgical intervention. In this procedure, a bone plug blocks the portion of the inner ear which is causing the dizziness. When this plug is placed it prevents the semicircular canal from being able to respond to particle movements.
How can BPV affect the long term?
It is challenging to live with BPV as it can affect the quality of relationships with friends and family and reduce work productivity. An ENT doctor will be able to improve this uncomfortable condition to help you to improve with time.
When to see an ENT doctor for BPPV?
A doctor should be seen if there are sudden, severe or recurrent episodes of prolonged and unexplained vertigo. One must seek emergency care if along with the vertigo, there is fever, headaches, double vision, trouble speaking or limb weakness and numbness.
How to plan for the Doctor’s appointment for BPV?
It will be helpful to write down the symptoms you have and make a note of any recent trauma to the head or other vital medical information which you would like to discuss. Also take a note of the questions you like to clarify from your ENT doctor.
The ENT Clinic led by ENT Specialist Dr Jeeve, Dr Annabelle and Dr. Chris Hobbs in Singapore is a state of the art medical facility catering to all paediatric and adult ENT maladies. Conveniently located in Mt. Elizabeth Novena and GlenEagles Hospital, this ENT centre has reputed, well qualified and foreign trained ENT surgeons who could quickly diagnose and treat all your ENT woes.
