TACKLING BENIGN PAROXYSMAL POSITIONAL VERTIGO

Dr Arun Oommen MBBS, MS (Gen Surg), Mch( Neurosurgery), MRCSEd, MBA Consultant Neurosurgeon, VPS Lakeshore Hospital Kochi, India

- Dr Arun Oommen

A 53-year-old computer professional has problem of recurrent vertigo. It comes suddenly and really makes her helpless. Many at times there is a tendency to fall with a nauseating sensation. Vertigo is maximum in the morning. Many medications tried but no permanent relief. Have seen so many doctors and have done many tests. But all seem normal. Tried many exercises as per doctors’ advice but has not produce any satisfactory relief.

What can be the permanent solution for this disgusting problem?

Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the inner ear’s vestibular system, which is a vital part of maintaining balance. Usually benign and generally not progressive. BPPV produces a sensation of spinning called vertigo that is both paroxysmal and positional, meaning it occurs suddenly and with a change in head position. Its typically unilateral, although in some cases it is bilateral.

BPPV occurs as a result of otoconia, tiny crystals of calcium carbonate that are a normal part of the inner ear’s anatomy, detaching from the otolithic membrane in the utricle and collecting in one of the semicircular canals. When the head is still, gravity causes the otoconia to clump and settle. When the head moves, the otoconia shift. This stimulates the cupula to send false signals to the brain, producing vertigo and triggering nystagmus (involuntary eye movements).

Symptoms