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How Is Benign Positional Paroxysmal Vertigo Treated ?

Posted on Wed, 25 Apr 2012

Question: hi,ive had a problem for years,and it is ruining my life,my vision and balance are the worst effected,my vision through my eyes (is the only way i can describe)like watching an old western,you know,all the small spots,(like its not the hd that a normal vision would give you).this in turn effects my balance,when i turn round,bend down,look up etc i go dizzy for approx 20_30 secs.i feel i have a tight back all over too,and any slight motion or even wiggleing my toes in bed,is enough to set off a wave of dizziness.everything has been checked,(blood,blood pressure,scans etc)everything is normal. i feel lightheaded just walking about,when the car stops at a stand still i get very dizzy too,i just feel off balance all the time and just not normal.if i clench my buttocks or move my buttocks very slightly i get very dizzy,what could be causing this?i have lower back pain and tightness too,would any back issue cause these symptoms,or something neurological?its driving me crazy,thanks and sorry for the long post.

Answered by Dr. Shiva Kumar R (18 hours later)

Hi,
Thanks for the query.

The symptoms you have described looks like you are suffering from

1. Benign positional paroxysmal vertigo - which makes you dizzy because of problems in the rotation of the fluid in the ears. This can be corrected and cured if we can identify which ear is involved. This is done by Dix-Hallpike test.

Once we confirm you have to undergo repositioning (Epley Maneuvre) and you will be cured. This sometime can also cause visual problems due to nystagmus. However we have to rule out problems in the eyes also.

2. Lower back pain is due to Lumbar Spondylosis. Lower back pains does not make you dizzy.
Only the movement of the body which disturbs the fluid in the ear will make you feel dizzy.

So you will have to consult a ENT specialist to confirm the diagnosis and get yourself treated for the problem.

Hope i have answered your query.I will be available for follow up.
Take care.

Bye

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Shiva Kumar R (5 hours later)

thanks for your answer doctor,can you tell me why its only the slightest movement that makes me dizzy,why does it not happen with larger movements,only the very very slightest movement sets of a wave of lightheadedness or dizziness for about 10 seconds.and also is it possible to have bppv without the nystagmus.would the bppv still effect my vision.would vrt exercises help too,i was told to try them because i was anxious about doing the epley.i was also going to do the home manouvre but dont want to make things worse. thank you for your response.

Answered by Dr. Shiva Kumar R (5 hours later)

Hi,

Thanks for following me.

Any movement either slightest or larger movements can make you feel dizzy, but only when it creates imbalance between the two ears. If there is no imbalance it does not occur.

BPPV most of the time has nystagmus (rolling movements of eyes) associated with it. But when it is very subtle it can be picked up only on wearing Frenzel glasses or Video nystagmography. The direction of the nystagmus helps us to find out the malfunctioning semicircular canal (you know there are three on each side). After finding the particular semicircular canal which is abnormal Epley maneuvre is to be performed. If you want to try Home treatments for BPPV, Brandt Daroff ecercises can be done. But this takes long time like 6 months to one year to get adequate response.

So my advise is to find out the abnormal semicircular canal and get it treated by Epley maneuvre. This is done by Otologist and Neurologists in your area. Even a GP with experience are able to do these now.

Hope this helps.

Bye

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar