Don’t Worry. They’re Supposed to be There

You may have heard of this condition being referred to as having “rocks loose in your head”, ear rocks, your “crystals” being out, and my favorite, your “gyroscope” being off. Let’s review what BPPV means

  • Benign: means it is not life threatening
  • Paroxysmal: means a sudden onset
  • Positional: means you have to put yourself in a certain position to make it happen
  • Vertigo: means objects moving in the environment/room spinning.

So, What’s going On?

During head movements, your brain moves your eyes to keep your vision clear based on the information it gets from your vestibular system (your inner ear). Your inner ear contains three fluid-filled canals oriented in the direction(s) you move your head. During head movement, the fluid in the canals move, causing your vestibular system to be activated. The movement of the fluid within your semicircular canals tells your brain which direction and how fast you are moving your head. In turn, your brain contracts muscles around your eyes causing them to move the same speed, with the goal of keeping your visual environment stable. BPPV happens when calcium carbonate crystals (rocks) that are a normal part of your inner ear, break off and float into one of the canals. Certain head positions cause the crystals to move turning your inner ear on and sending a signal to your brain that you are moving your head when you are not. The most common head positions are looking/reaching up or down, rolling to one side in bed, lying down, or sitting up quickly in bed, bending to pick something up. As a result, your brain moves your eyes suddenly making it look as if the whole world is spinning (vertigo). These crystals stay within the canal and do not move anywhere else or cause problems anywhere else in the body (“benign”). Symptoms can last from a few seconds to over a minute, but are usually in the 10-15 second range.

How Is it Treated?

Treatment for BPPV is called a particle repositioning technique, and is specific to which of the three semicircular canals is involved. A Dix-Hallpike maneuver is performed to detect which canal the crystals have moved into. This is a positioning technique to observe eye movements and determine which canal the crystals have moved into. Once the symptoms have subsided, our clinicians move your head through a series of positions placing the crystals back where they belong. The particle repositioning techniques (most common one is called the Eply maneuver) are highly successful. We enjoy a 95% success rate in our clinics with the treatment of BPPV. Other symptoms caused by BPPV may include dizziness (light headedness), imbalance, trouble concentrating, and nausea. If not evaluated and treated correctly, BPPV can lead to decreased quality of life issues, and functional disability with many activities of daily living.

*Don’t Try to Treat Yourself!

We caution using self-treatment techniques as seen on the internet or given to you by a medical professional. Firstly, we perform a vertebral artery test prior to testing to determine if the positioning technique may cause a decrease in blood flow to your brain. Secondly, treatment is only successful if the correct treatment technique is performed after observing eye movement during the Dix-Hallpike test.