Untreated BPPV can lead to falls, injuries

Q. My grandmother told me she has BPPV and it makes her head spin. What exactly is this BPPV?

BPPV stands for benign paroxysmal positional vertigo. It usually strikes when you change the position of your head.

We have to define terms first. Vertigo is the feeling that either you or your surroundings are spinning. It is more than being just lightheaded or dizzy, because you are subjected to the illusion of movement. If you feel your body is moving, you have subjective vertigo. When you sense that your surroundings are moving, you have objective vertigo.

BPPV occurs most often in people 60 and older. It is rarely a serious condition unless it makes you fall. The odds of falling each year after age 65 in the United States are about one in three. And falls are the leading cause of injury and injury-related death among older adults.

Other symptoms besides spinning include: dizziness, loss of balance, blurred vision, nausea and vomiting. The symptoms of BPPV can be irregular. They usually last less than a minute. Episodes can disappear and then come back later.

BPPV is caused by a problem in the inner ear, which contains crystals that make you sensitive to movement. If these crystals are dislodged, you can feel dizzy and experience vertigo.

Besides aging, a head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Among the diagnostic tools for BPPV are electronystagmography (ENG), videonystagmography (VNG) and magnetic resonance imaging (MRI).

The ENG, which uses electrodes, or the VNG, which is done with small cameras, can help determine if dizziness is caused by inner-ear problems by measuring involuntary eye movements while your head is placed in different positions.

The MRI uses a magnetic field and radio waves to create cross-sectional images of your head. MRI may be performed to rule out lesions that may cause vertigo.

A common treatment for BPPV is known as the canalith repositioning procedure. This is done in a doctor's office. The procedure consists of maneuvers for positioning your head. The aim of the treatment is to move troublesome crystals that have been dislodged.

The canalith repositioning procedure is usually effective after one or two treatments. However, in rare situations when the procedure doesn't work, doctors may recommend corrective surgery.