Altea Physiotherapy + Wellness Blog

BPPV Explained

Written by Carly

Carly Chuby is the vestibular therapist at Altea Physiotherapy and Wellness. She has been a certified vestibular therapist since 2017.

February 15, 2022

What are the crystals in my ear, and how did they fall out?!

First of all, let me paint a picture so you can visualize this better. The vestibular apparatus, which includes the semicircular canals (senses head movement) and the cochlea (hearing organ), and is the purple thing in this photo, are in-cased deep in your skull and is the size of a dime! This system is extremely important to help you maintain your balance and it is constantly sending signals to your brain telling it where your head is in space so you don’t fall or lean over to far.

The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV), which is the false sense of spinning you get with certain movements or positions.

Benign means not life threatening.
Paroxysmal means sudden brief spell.
Positional means this type of vestibular disorder is triggered by certain body or head movements.
Vertigo means a false sense of rotational movement.

If you or someone you know has or has had BPPV you know this can be one of the most horrible experiences! Good news though, it is very simple to fix!Unlike other vestibular disorders, BPPV is a mechanical problem, meaning it can be fixed with a specific procedure done in clinic.

How does this happen?

BPPV occurs when some of the calcium carbonate crystals in your inner ear fall out of the place they should be. When enough of these crystals fall out of place it affects the normal fluid movement in these canals which are used to sense head movements, causing the inner ear to send very wrong and alarming signals to the brain. The most common example of this would be when you roll over in bed. If you have BPPV, the crystals that are out of place willcause the fluid to move around

when you roll over, which will send a DANGER signal to your brain because your inner ear is telling your brain; YOU ARE SPINNING ON A MERRY-GO-ROUND BE CAREFUL!! And you will feel the sensation of vertigo during this. Thissensation typically lasts about 60 seconds.


What causes BPPV?

It is not entirely clear what causes BPPV, but there have been links made with head trauma, migraine, inner ear infections or disease, diabetes, osteoporosis, prolonged intubation, and people who ALWAYS sleep on one side.

How is it diagnosed?

Diagnosis of BPPV is made using VNG or infrared goggles which allows the therapist to see your eye movements in a zero-light environment. They will bring you into certain positions, which will trigger an episode. During the episode nystagmus (very specific eye movements) will occur and inform the therapist that you have BPPV and which canal it is in.

How is it treated?

There are a total of 6 canals in your inner ears, and each canal can be affected with BPPV. There are very specific crystal repositioning maneuvers performed depending on what the therapist sees during examination. These maneuvers help guide the crystals back into their proper place. Each of these maneuvers only takes about 4 minutes to perform!

If you think you may be suffering from BPPV, Carly our certified vestibular therapist would be happy to guide you through recovery and get back to the things you love! You can give us a call, book online, or email us. 250 596 0101.

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