top of page

Benign Paroxysmal Positional Vertigo: What do you mean by I have fluid imbalance in my ear?

Updated: May 29

Benign Paroxysmal Positional Vertigo (BPPV), or fluid imbalance in the ear, is a unique spinning sensation that usually triggered by specific changes in the head position, for example, lying down, getting up from sitting, bending forward, and so on. This articles talks about the basic information on BPPV and self-maneuvers to test and treat BPPV.

Study found that, dizziness, including BPPV and other types of dizziness, affects 10% of younger adults (Kerrigan MA et al, 2013), and this number increased with age. When you reached the age of 80, there is a 10% possibility that you have experienced BPPV for at least once (M Von Brevern et al, 2007). However, for those who are diagnosed BPPV, only 8% of them received effective treatment (Von Brevern M et al, 2007).

BPPV is caused by the displacement of calcium crystal, otoconia, that function as motion sensors in the inner ear balance system into the nearby semicircular canals (Parnes LS, McClure JA, 1992). However, the cause of the displacement of this calcium crystal remains unknown. The good news is BPPV is the most treatable cause of dizziness.

There are 3 types of BPPV, the anterior, the posterior, and the lateral. depends on which semicircular canal the calcium crystal dislodged into. The posterior BPPV is the most common types of BPPV with can be treated with the similar repositioning maneuver for anterior BPPV. Lateral BPPV is less common and will require another type of repositioning maneuver (Katsarkas A, 1999).

The table on the left illustrates the percentage of complaining symptoms and triggering factors (precipitating head movement) experienced by 80 BPPV patients.

Oscillopsia, means the feeling of surrounding environment is constantly moving, despite the subject is stationary.

For the diagnostic criteria, the dizziness has to be (i) rotational in nature, (ii) triggered by changes in head position, (iii) recurrent with changes in head position, (iv) symptoms lasted for less that 1 minutes and subsided slowly, and (v) not contributed by other condition(s) or medication(s).

Other conditions that might present with similar symptoms are vestibular neuritis, vestibular migraine, Meniere’s disease, neurolabyrinthitis, stroke, sudden sensorineural hearing loss (K Hanley et al, 2001), and maglinant paroxysmal position vertigo (Alessandro D S, 2011; Dunniway H M, 1998). Uptake of medications, including antidepressants, anticonvulsants, tranquilizers, anxiolytics, sedatives, muscle relaxants, strong analgesics, and antiarrythmics, may cause positional vertigo as well.

To differentiate BPPV from other diseases, dizziness results from BPPV always triggered by specific changes of the head positions, and only lasted for around 1 minute. Other diseases usually accompanied with symptoms other than dizziniess. For example, stroke patients usually present with weakness, numbness, loss of consciousness and so on. Ear infection most of the time, will present with pain and fever. However, if you are not sure if your dizziness is casued by BPPV, you should seek professional medical review.

If you are very sure that you are suffering from BPPV, you may attempt the treatment maneuvers in the video below. There is an English version, as well as a Chinese version.

However, these home-based treatment maneuvers is not suitable for those with the conditions in the diagram.

If you fall under this "Do Not Perform" list, or you are not sure if your dizziness is caused by BPPV, or you do not feel any improvement after performing these maneuvers, please seek professional medical helps. The Rehab Studio offer home visit physiotherapy service to help you with you dizziness, to diagnose your problem, and make proper referral.

If you need help with your dizziness, feel free to give us a call at 88920350!


bottom of page