One morning, without any warning, I was walking into walls – or, I would have if I hadn’t stopped myself. When I sat down, the floor was spinning. When I stood up, I was shaky and nauseous. I couldn’t walk without veering to the left. My doctor diagnosed my condition as vertigo, most likely brought about because of an inner ear infection that had caused the crystals (who knew we have rocks in our ears) to become dislodged.
Although my condition was supposed to improve within a week or two, six weeks later the floor was still spinning, and I continued to have bouts of instability. My doctor referred me to a physical therapist, whose diagnosis was benign paroxysmal positional vertigo (BPPV).
BPPV and its Causes
The inner ear contains hundreds of tiny crystals, which are small calcium stones in the inner ear. These crystals help control our balance, but if the crystals break apart and move into one of the inner ear canals, our brain receives the wrong signals. We think our head is moving a lot more than it really is.
This condition, known as BPPV, can be caused by an injury to the head, aging, infection, or inflammation of the inner ear. BPPV can affect people of all ages, but is more prevalent among people over 50 years old.
Symptoms of BPPV
The most common symptoms of BPPV are dizziness, feeling as though your surroundings are spinning or moving, lightheadedness, unsteadiness, loss of balance, and nausea.
These symptoms, because they come on suddenly and for no apparent reason, can be quite alarming. BPPV may correct itself within a few weeks, but professional intervention may be necessary.
Testing for BPPV
BPPV is diagnosed by determining if vertigo is caused by certain head positions. Infrared goggles are placed around the patient’s eyes, and as the head is moved in different positions, the eyes are carefully monitored for involuntary movements. This test, the Dix-Hallpike, can also help to determine which ear is affected.
Testing consists of the following steps:
The therapist turns your head toward one side and helps you quickly lie back so that your head hangs over the end of the table. The therapist monitors your eyes for involuntary eye movements, called nystagmus. The timing and appearance of the eye movements will identify the cause of vertigo as either the inner ear or brain. The therapists repeats the procedure, with your head turned to the other side.
One of the methods of treatment, which I received, is the Epley Maneuver. Through a series of head and trunk position changes, eye movements are closely monitored. Positional changes are determined by evaluating the eye movements. The goal is to encourage the crystals back into their proper position.
The therapy is similar to the diagnostic test:
The therapist turns your head toward one side and helps you quickly lie back so that your head hangs over the end of the table. The therapist monitors your eyes to determine what positions will coax the crystals back into place The therapist changes your head position, as appropriate, until your eye movements indicate the crystals are back in place.
The Epley Maneuver is successful 80% of the time, but more than one session may be necessary. It took me five sessions to rid myself of BPPV. I began my therapy sessions as a skeptic, but in the end, I became a true believer – crystal relignment therapy really works.