Vestibular Assessment at Milltown Physiotherapy

Here is Laura Fitzpatrick our physiotherapist with a special interest in Vestibular Assessment giving us the low down on BPPV (benign paroxysmal positional vertigo), one of the most common causes of dizziness/spinning/vertigo. It is a condition that she treats regularly at the clinic with great outcomes. Vestibular assessment is a special interest area of physiotherapy. It deals with dizziness and balance issues primarily.What is BPPV?BPPV is a condition arising in the inner ear. It is a sudden but short-lived sensation of spinning when your head is in a certain position, for eg. turning in bed or going from sitting to lying. The dizziness can range from being mild to severe and there is normally a sudden onset of symptoms- one day you have no dizziness and the next you do.Signs that you may have BPPV.Nausea with or without vomiting associated with your spinning Mild to severe spinning when you have your head in certain positions A feeling of unsteadiness Difficulty with balanceThe spinning/dizzy sensation normally only lasts for a few seconds but sometimes can continue while your head remains in a certain position.BPPV is not normally a serious condition, however it can be very worrying, so do seek treatment if you are concerned.More women than men are affected by BPPV and having had a head injury can make you more susceptible to BPPV.What causes BPPV?Very often there is no known cause for your symptoms arising. This is known as idiopathic BPPV. Sometimes it coincides with an episode of illness, like a viral infection. It can also be caused by having your head in unusual positions like on the dentist chair.Our ears play a major role in BPPV. We have 3 small canals in each of our ears, these are called semi-circular canals. These canals monitor the rotation of our head and help to tell us what way our head is positioned.We also have tiny crystals in our inner ears which help make our bodies sensitive to gravity. These crystals can become dislodged and end up in our semi-circular canals. This is what causes your spinning/dizziness. The canals have now become sensitive to movements that they would not normally respond to.Diagnosis and treatmentWhen you come for your assessment your physiotherapist will first take a complete history of your symptoms. They may ask about your cardiac history and about things like migraines, headaches and your hearing. This is to help rule out any other reason for your dizziness. If you have results of recent investigations like a brain CT or MRI, make sure to bring them with you to your assessment.Then a number of tests will be performed on you to ascertain whether or not you have BPPV.Once you have been diagnosed with BPPV your physiotherapist will then perform a repositioning manoeuvre. The aim of this is to reposition the crystals so that your semi-circular canals are no longer over sensitive to normal movements.This repositioning involves a number of specific head movements held for a certain amount of time. You should notice that your symptoms are much better with the re-test that will be carried out at the end of your assessment.We do ask that you bring someone along with you to your assessment.BPPV is just one of many vestibular conditions that can be treated with vestibular physiotherapy. Please ring the clinic if you would like any further information or to book an appointment.