Vertigo – Crystal Displacement BBPV

The cause of BPPV may not always be clearly determined. However, clinical observations and scientific studies indicate some risk factors.
The most common causes
• Head trauma
• Inner ear infections
• Prolonged bed rest
• Age-related degenerative changes
Possible risk factors
• Being over 50 years old
• Previous vertigo attacks
• Osteoporosis
• Migraine history
In some patients, BPPV may develop without any triggering factors.

The most typical symptom of BPPV is sudden and short-lived dizziness that occurs when the head is turned in certain directions.
The most common symptoms
• Dizziness while turning in bed
• Severe dizziness when getting out of bed in the morning
• Dizziness when looking up or bending over
• Feeling of imbalance
• Nausea and sometimes vomiting

• Hearing loss
• Ringing in the ears
• Ear fullness
If these symptoms are present, an evaluation for other inner ear or neurological diseases is required.

The diagnosis of BPPV is often made with the patient’s history and a detailed ear-nose-throat examination. The most frequently used test in the diagnosis is the Dix-Hallpike maneuver. During this test, the patient’s head is brought to certain positions and involuntary eye movements (nystagmus) are evaluated along with dizziness.

Differential diagnosis:
BPPV (crystal displacement); May be confused with Meniere’s disease, vestibular neuritis, vestibular migraine, and central vertigo. For this reason, it is extremely important that the diagnosis is made by a specialist.

The main purpose of BPPV treatment is to direct the dislodged crystals to a region in the inner ear where they will not cause complaints.
Maneuver treatments
The most effective and most frequently used method is the Epley maneuver. When performed properly, it provides rapid and permanent improvement in a large majority of patients. More different maneuvers can be applied according to the canal where the crystals are displaced.
Drug treatment
Drugs do not eliminate the cause of BPPV, they can only temporarily reduce the feeling of nausea and dizziness. Therefore, it is not a permanent solution on its own.
Surgical treatment
In very rare cases, if no response is obtained from maneuver treatments, surgical options may be considered.
Post-Treatment Process
Most patients feel relief within the same day after the maneuver treatment.

• Avoid sudden head movements for the duration recommended by your doctor
• Perform the exercises recommended by your doctor regularly if necessary
• If dizziness recurs, come for a check-up

BPPV may recur in some patients over time. Recurrence is more likely, especially in older people and those with underlying risk factors. However, with early diagnosis and correct treatment, the frequency and severity of attacks can be reduced.

In some mild cases, BPPV may resolve on its own. However, if symptoms persist or are affecting quality of life, a specialist in ear, nose, and throat should be consulted.