Sunday, March 23, 2014

BPPV revisited

A while back I wrote about Benign Paroxysmal Positional Vertigo or BPPV for short. It is a condition which although not life threatening is common, profoundly disturbing, often anxiety producing and inadequately treated. A sense of balance is fundamental to normal day to day activity and this problem doesn't just make you feel 'off' as many spinal problems can do. BPPV is a sudden and disturbing spinning sensation (most often associated with movement such as rolling over in bed) accompanied by nausea, sweating and anxiety and visual disturbance. Futhermore even once an attack has passed the experience is such that most people remain highly anxious or hypervigilant. This in itself is a normal response by the brain which has evolved to force you to pay particular attention to sensations which may threaten your survival and falling over is a main one. Think of the times your pesky brother sneaked up on you at lovers leap. Now magnify that sensation of threat, add in a manic childs roundabout and you have BPPV.

Fortunately it's diagnosis is easily confirmed and 90% respond well to treatment. In contrast is Menieres disease which is currently thought to be due to a disturbance in the fluid of the inner ear (endolymph).