Benign Paroxysmal Positional Vertigo (BPPV) is a common disorder of the inner ear that leads to brief episodes of vertigo (a spinning sensation) triggered by specific changes in head position. It is one of the most common causes of vertigo, however we see rates of BPPV increase in people who already have a vestibular disorder. In people with Meniere's Disease, for example, we see rates as high as 38%, and in people with Vestibular Migraine, we see BPPV 3x more often than in those without vestibular migraines.
But why is this? This type of BPPV is referred to as secondary BPPV, meaning it occurs when there is already a disorder of the vestibular system.
Why do we get Secondary BPPV?
We believe this is due to a reduce function of the Dark Cells within our inner ear. Dark Cells exist to absorb any loose particles (such as crystals or otoconia). If these Dark Cells aren't functioning properly, there is reason to believe that more particles are floating around in the inner ear and there is an increased chance that these can migrate into the semicircular canals and cause BPPV.
How do I tell the Difference between Vertigo from BPPV and other Vestibular Disorders?
If you have Meniere's, Vestibular Migraines, or any other vestibular disorder, it's important to be aware of the symptoms of BPPV and recognize how these differ from you current symptoms. It can be challenging to differentiate, but here are some general rules to help you distinguish BPPV:
Vertigo or dizziness due to BPPV will be for a short duration (typically less than 1 minute), where as vertigo experienced with other disorders will last longer (multiple minutes to hours).
You may see the room spin and it may feel different than your normal sensations of dizziness or vertigo.
Vertigo is typically brought on when you lie down and roll over in bed. The Vertigo Quiz is a good resource to refer to for BPPV specific triggers. Vertigo due to Meniere's or Vestibular Migraine can occur spontaneously, from visual stimulation, triggers such as weather, stress and poor sleep, and may not be associated with any head position change.
Vertigo due to BPPV tends to be an isolated symptom, and you will feel fine between vertigo sensations. Vertigo due to Meniere's or Vestibular Migraine will often be associated with other symptoms including headache, sensitivity to light and sound and visual disturbances and you may still feel some of these other symptoms between vertigo attacks.
Working with an experienced vestibular therapist, such as the ones at Healing Vertigo, can help you manage multiple vestibular disorders. And once you feel comfortable knowing when you have BPPV, you can use resources such as the Healing Vertigo App to treat this on your own.
About the Author
Cheryl Wylie, is a vestibular physiotherapist and owner of Healing Vertigo. She is also the creator of our Vertigo Treatment App, and instructs vestibular courses to other healthcare professionals.
She offers vestibular therapy for all Ontario Residents. If you're interested in working with Cheryl, connect below!
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