Benign Positional Dizziness (BPP)

Each of us throughout his life at least once, but was dizzy. It can occur for a variety of reasons, it can be from ordinary fatigue or during pregnancy, for example.

There can be many varieties of this pathology, as well as the causes of this condition. One of them is benign positional dizziness. Many have not even heard of such a diagnosis, but this does not protect them from the occurrence of such a pathology. Let's see what kind of disease it is, whether it is so scary and whether it is possible to cope with it.

Nature of the disease

Benign paroxysmal positional dizziness (DPPG) is one of the types of this pathology that can be observed when changing the position of the trunk or head in space. It is believed that the cause is irritation of ear otoliths located in its inner part on the eve of the auditory canal. There are some external influences that provoke the rejection of otoliths from the walls, they begin to move freely, touch the receptors and cause severe dizziness. This leads to disorientation in space, this condition requires medical attention.

The word "benign" in the name of the disease suggests that this pathology does not apply to serious disorders of the nervous system.

For what reasons does the disease develop?

According to doctors, the accumulation of calcium salts in the inner ear can lead to the development of this pathology. Statoliths break away from the otolith membrane and move freely during the movement of the body or head, thereby causing dizziness.

Quite often there are cases when this pathology begins to manifest itself with cervical osteochondrosis. But in most cases, if you mean benign positional dizziness, the reasons are difficult to establish. Specialists in this category include the following factors:

1. Head injuries.
2. Surgical operations performed not very competently.
3. Meniere's disease.
4. Some antibiotics, such as Gentamicin, can provoke dizziness.
5. The presence of an inflammatory process in the ear canals.
6. Frequent migraines that are triggered by spasm of blood vessels passing through the maze.
7. For some, even a prolonged fixed position of the head can cause dizziness.
8. Age-related changes can also be attributed to causes.

Most often, benign positional dizziness is registered in women older than 50 years. In children and at a young age, pathology practically does not occur.

Symptoms of the disease

Pathology can manifest itself in different ways, but most often benign positional dizziness, symptoms have the following:

1. Often an attack begins its development at a certain position of the body or head.
   
2. This happens when bending the neck or turning the head.
3. The duration of the condition does not exceed 30 seconds.
4. Patients, as a rule, with high accuracy can tell which side they have an attack.
5. Often dizziness is accompanied by nausea.
6. Attacks can be either single or repeated several times a day.
7. Without provocative movements, dizziness does not appear.

It should be noted that with this pathology there is no headache, pain in the ears or hearing impairment.

Types of disease

Given that the pathological process can develop in any ear, we distinguish between right-sided and left-sided vertigo. The mechanism of the disease may also differ, therefore, the following types of it are distinguished:

• Cupulolithiasis. With this form, otoliths constantly irritate the ear receptors and are more fixed to one channel wall.
• Canalolithiasis - otoliths move freely and, with unsuccessful movement of the head, provoke an attack.

If benign positional dizziness is diagnosed, treatment will depend on the form of the disease and the degree of its manifestation.

Pathology diagnostics

If you are constantly worried about strange dizziness, which you are not able to explain for any reason, then you should visit a specialist. The doctor will ask about all the symptoms when all the manifestations begin.

On the part of the patient, it is required to clarify what provokes the attacks and how long they last. The doctor will conduct an examination, which includes various diagnostic methods:

• Dicks-Hallpike test. The patient is invited to change the position of the head and torso, and the doctor observes his reaction.
• With some doubt, an MRI scan is performed.
• Computed tomography of the cervical spine.

The doctor may refer you to a consultation with an otolaryngologist, neurologist and vestibulologist.

Principles of Therapy

If there is benign paroxysmal positional dizziness, treatment may not be required in every case. It often happens that seizures themselves leave a person and are no longer disturbed. But hoping for it is also unreasonable, as they can return with even greater power and repetition rate.

In such a situation, there is no escape from therapy; you will have to visit a doctor. Specialists in the treatment use several areas, such as:

1. Non-drug treatment.
2. Drug therapy.
3. Surgical intervention.

This issue in each case is decided individually.

Medication-Free Techniques

You can try to cope with the pathology without medication. There is a good reception of Epley, which consists in the fact that a change in the position of the head is carried out in a certain sequence. The otoliths emerge from the semicircular canal on its eve. If there are no improvements, then the deterioration also does not threaten after such exercises.

Good results are obtained if there is benign paroxysmal positional dizziness, vestibular gymnastics. The best known is the Brandt-Daroff method, here is what it consists of:

1. In the morning, immediately after waking up, sit on the bed with your back straight.
2. Then lie on either side and tilt your head up a little.
3. In this position, stay for 45 seconds or until dizziness passes if it occurs.
4. Then repeat on the other side.
5. Exercise is enough to perform 5 times in each direction.
6. If dizziness is observed during execution, then all exercises should be done in the evening.
   

Doctors have the Semont method and Lempert’s maneuver in stock, but they are best used under the supervision of a doctor. Exercises are performed at a fairly high speed. Therefore, often dizziness is also accompanied by nausea. The specialist monitors the condition of the patient and adjusts the load.

Here is the Semont technique:

1. The patient should sit down and lower his legs.
2. Turn your head 45 degrees to the healthy side.
3. Wrap your arms around and lie in that position.
4. Maintain a position until the cessation of dizziness.
5. The same thing is done on the other side.
6. If necessary, then all actions are repeated.

Lempert Maneuver:

• The patient sits along the couch and turns his head 45 degrees to the sore side.
• The doctor holds the head of a person throughout the exercise.

• The patient lies on his back and turns his head in the opposite direction.
• Then turn in a healthy direction.
• It is necessary to turn and the body, from a prone position.
• Head nose down.
• All changes in body position are accompanied by turns of the head.

As a rule, such exercises give good results, and most patients do not even need further medical treatment if benign paroxysmal positional dizziness occurs to a mild degree.

Drug therapy of the disease

Most doctors believe that the use of drugs with this pathology does not give good results and does not completely relieve dizziness. But sometimes, specialists still prescribe medications to improve the patient’s condition.

If the diagnosis is "benign paroxysmal positional dizziness", drug treatment can give the following effect:

• Nausea is reduced.
• The emotional state improves.
• Blood circulation in the brain improves.

If the attacks are repeated often and with great intensity, then the patient is recommended bed rest for a while.

Surgical intervention

In the most severe cases, when drug therapy and vestibular gymnastics do not help, benign positional dizziness has to be eliminated by surgical methods. There are two methods of surgery:

1. Blockage with wax to prevent fluid movement.
2. A nerve is cut off from the inner ear.

Surgical intervention, although it does not damage the hearing, but often gives complications. Laser treatments are being developed and tested.

Now benign paroxysmal positional dizziness, the causes of which can be any, can not be cured by specific drugs. Therapy is prescribed individually in each case.

Pathology Prevention

There are few diseases that would not have specific preventive measures. But benign positional dizziness just belongs to those. How to protect yourself from this pathology is unknown, but you can give patients some recommendations:

• Avoid head injuries, at the slightest suspicion of this, you must urgently visit a doctor.
• Protect your ears and avoid injury.
• Training the vestibular apparatus will also come in handy.

• Timely undergo treatment of all chronic pathologies. This will help reduce the risk of dizziness or relapse.

Any deviations from full health should not go unnoticed. A timely visit to a doctor will help to avoid complications. As it turned out, even ordinary dizziness can be associated with serious problems.