What is the difference between BPPV dizziness and non-BPPV dizziness, and how does this affect treatment?
BPPV stands for Benign Paroxysmal Positional Vertigo. This is one of the most common cause of vertigo seen in my clinical practice. In BPPV, there are calcium deposits or small "stones"/"cystals" in the inner ear balance system. Head movements result in movements of these "stones", triggering the balance system of the inner ear, resulting in vertigo. Vertigo is a type of giddiness in which the sufferer experiences a spinning sensation.
The typical presentation of a patient with BPPV is vertigo that is triggered by sudden head movements (e.g. from waking up from bed, having a hair wash in the hair salon etc). The vertigo usually lasts for a few seconds to minutes and may be accompanied by nausea or vomiting.
A simple test for BPPV known as a Dix Hallpike test can be performed in the clinic. This involves turning the patient's head 45 degrees to the right/left and lowering the patient's upper body and head down, with the head lying approximately 30 degrees below the horizontal level. If the patient has BPPV, he/she will experience vertigo and there will be jerky movement of the eyes (known as nystagmus).
Most BPPV is treated with an Epley's Manoeuvre. This manoeuvre aims to "roll" the "stones" out of the inner ear canal. This manoeuvre is highly successful with approximately 85-90% cure rate. However, it is known that there is a 10-15% chance of recurrence each year, even after successful treatment.
Hope this helps and all the best!
Dr Gan Eng Cern
MBBS, MRCS, MMed, FAMS
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Specialist Centre
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