Semicircular Canal Abnormalities

Causes of BPPV

Benign Paroxysmal Positional Vertigo (BBPV) is caused when otoconia, tiny calcium crystals dislodge from the utricle. The utricle is a sensory organ in the inner ear. These dislodged otoconia flow freely in the fluid filled spaces of the semicircular canals. Sometimes they may form a large clump. Due to the heavy clump, the otoconia usually fall into the posterior semicircular canal, the lowest part. Whenever the head changes positions, these tiny calcium crystals move in the semicircular canals causing dizziness, like the world is spinning around you. These are several causes for BPPV, some which include:
Vestibular migraines
Head in the same position for a long time
Slight to abrupt movement of head
Walking or riding on rough trails
High intensity aerobics
Labyrinthine conditions-viral or vascular
Mild to severe head trauma

Symptoms of BPPV

Positional Vertigo is one of the most common types of dizziness experienced by adults. These episodes are usually brief, but can be severe. Sometimes nausea follows positional vertigo. The lifestyles of many sufferers are restricted from slight movement during sleep to its most severe condition that immobilizes a person. Other motion sickness like symptoms occur whenever a patient turns over in bed or get out of bed, tilt their back to look up high, or tip their head to look down low. The onset of BPPV may be frightening and cause the patient to fall and they may even think they’re having a stroke. The usual course of this illness is a gradual lessening of symptoms over a period of time from weeks to months to years.


Diagnosis of BPPV & Treatment:

The diagnosis of BBPV is made by characteristic symptoms and by observing the nystagmus. The jerking of the eyes when the position of their head is changed. The doctor will try to provoke the symptoms to see the nystagmus for a thorough diagnosis.

The treatment of BPPV is usually physical therapy maneuvers and or exercise programs designed to remove the stones from the semicircular canals. Once the stones are out, they are absorbed naturally over the course of days to weeks. But there’s always the risk of the stones falling back into the semicircular canals and getting stuck again. In some cases a hand held vibrator is applied to the bone behind the ear to help dislodge the stones. If the posterior or lateral canals are involved with stones, slightly, different therapy maneuvers are used. It is based upon the same principle, with respect to the pull of gravity to move the stones out of the offending semicircular canal. BPPV of the anterior canal is very rare because these stones easily fall out on their own due to their location (at the top of the inner ear).

Usually no medications are given for BPPV, unless required for a patient with severe nausea or vomiting. Surgery is rarely performed to plug the posterior semicircular canal to prevent otoconia from moving within the canal. “The past surgical solution was not worth the risk,” notes Timothy Molony, a neuron-otologist at the Ochsner Ear Institute. The surgical plugging procedure cures the problem, but it may carry some risks-like hearing loss. About 20%-30% BPPV patients are treated again due to the symptoms recurs within the first week. Over the long term, BPPV recurs about half the time. In about 70%-80%, a cure is immediate. BPPV can also be diagnosed and successfully treated with no pills, no test, no special equipment, and no surgery.

For more information go to: www.encyclopedia.com and www.hopkinsneuro.org/vestibular/disease.cfm