Benign Paroxysmal Positional Vertigo (BPPV)
Dr Tejaswini Patel, consultant - Neuro-Otology, Narayana Health
Usually, the first episode is seen while getting up from the bed. In BPPV, the patient feels a violent spinning sensation on getting up from bed, which may throw him back to bed along with severe vomiting and sweating. The sensation usually lasts for less than a minute but the whole cluster may last for 3-4 days.
Migraine is more common in females, between 20-40 years. Characterised by a throbbing one-sided headache, it usually increases with increased physical activity or restricts physical activity. It may also present with intolerance to head movements, loss of balance, neck pain, and tingling and numbness in limbs. It is quite commonly associated with anxiety. Balance problems may occur before, during or after headaches or may be completely independent of migraine. Some of the common triggers are
Food triggers-Cheese, paneer, noodles, coffee, tea, ice cream, chocolates, alcohol
Environmental triggers- Sunlight, sound, crowded places and AC
Others-Irregular sleep pattern, dehydration, hunger, lack of physical exercise
A healthy life style and avoiding substances or situations that trigger and make the condition worse may help.
In this condition, along with vertigo, patient also develops difficulty in hearing and ringing in the ear. Here the vertigo usually lasts for 2-3 hours along with severe vomiting and sweating. It is usually episodic, seen once in 3-4 months. The patient needs to see a vertigo specialist.
The following are some of the treatments adopted.
Positioning maneuvers- The patient is made to follow certain body postures and movements. The change in the head position helps in moving the dislocated calcium deposits into their position.
Vestibular rehabilitation therapy- A set of balance exercises to reduce the symptoms of gaze instability, imbalance, falls, head motion intolerance
Medications- To prevent the acute attacks and to prevent further attacks
Diet, lifestyle changes - Exercise, good sleep, adequate water intake, regular meals
Counselling and reassurance- Be it BPPV, Vestibular Migraine or Meniere’s disease they all present a huge emotional stress. Apart from medication, counseling plays a key role in ensuring faster recovery of the patient. Vertigo can be managed effectively. There is no need to be scared or feel helpless about it. We need to be aware and be empathetic.