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Writer's pictureDr. Alex Craig, D.C.

Understanding and Managing Benign Positional Vertigo (BPV)



Dr. Lasota, our clinic's Naturopath and homeopath, recently brought up a concerning issue during our routine Friday patient conference: dizziness. This prompted a discussion that shed light on one of the most common types of dizziness we encounter in our clinic: Benign Positional Vertigo, or BPV.

Typically, vertigo manifests as a sensation of spinning or the room whirling, often described by patients as "my head is spinning." These symptoms, occurring 90 percent of the time, are closely associated with BPV. However, it's important to acknowledge that other conditions, such as otitis media, Meniere’s syndrome, and certain medications, can also induce similar symptoms. Differentiating between types of dizziness is crucial; for instance, complaints of imbalance or feelings of faintness prompt us to explore neurological possibilities, while general dizziness or lightheadedness may signify something other than BPV.

During our examination, Dr. Lasota and I encountered a challenge in determining the appropriate side to perform the Epley maneuver, a common treatment for BPV, as she exhibited no nystagmus and felt symptoms on both sides of her head and around both ears. Experimentally, we attempted the maneuver by turning her head to the left side, which unfortunately exacerbated her symptoms. This led us to believe that the crystals causing her vertigo were likely situated on her right side, prompting us to adjust our approach accordingly.

BPV arises from various causes, primarily involving the detachment of tiny calcium carbonate crystals, known as otoconia or canaliths, from the utricle within the inner ear. These displaced crystals find their way into the semicircular canals, triggering vertigo upon changes in head position. Common instigators include head trauma, inner ear infections, ear surgery, or prolonged periods of bed rest. Interestingly, observations in our clinic suggest that allergy season and excessive vitamin D intake may also contribute to crystal formation within the inner ear, although moderate levels of vitamin D could potentially aid in their reduction.

Over the years, I've employed the Epley maneuver, also known as the "Eply’s maneuver," with consistent success, including in Dr. Lasota's case today. This non-invasive technique often yields near-immediate relief from vertigo symptoms. It's crucial to remind individuals experiencing vertigo symptoms that this effective treatment option is readily available and can provide significant relief without invasive procedures. If you or someone you know is grappling with vertigo symptoms, consider exploring the Epley maneuver as a viable solution to regain balance and improve quality of life.

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