BPPV Treatment For Vertigo In Regina

Benign paroxysmal positional vertigo (BPPV), or positional vertigo, is a common reason people feel dizzy. It happens when tiny calcium crystals in the inner ear, called otoconia, move out of place and enter one of the semicircular canals. Normally, these crystals stay in the utricle and help us sense gravity and movement. When they shift into a canal, they disrupt the ear’s balance system, sending the brain the wrong signals about head movement. This leads to short episodes of spinning dizziness, especially when you move your head.

People with positional vertigo typically experience symptoms when rolling over in bed, looking upward, bending down, or turning their head quickly. The sensation frequently lasts less than a minute but can feel intense and may be accompanied by nausea, imbalance, or a feeling of unsteadiness. BPPV is called “benign” because it is not life-threatening, and “paroxysmal” because the dizziness occurs suddenly in short bursts. The condition is most common in older adults but can also occur after head injuries, inner ear infections, or prolonged periods of lying down.

Each side of the inner ear has three semicircular canals: the posterior, horizontal (lateral), and anterior (superior) canals. These canals are set at different angles and help detect head rotation. BPPV can affect any of them, but the posterior canal is involved in most cases—about 80 to 90 percent. Each canal needs a specific repositioning maneuver to move the crystals back into the utricle, where they stop triggering dizziness.

When BPPV affects the posterior semicircular canal, doctors often use the Epley maneuver, also called the canalith repositioning procedure. This treatment uses gravity and a series of head and body movements to move the loose crystals through the canal.

The Epley maneuver starts with the patient sitting up and turning their head about 45 degrees toward the affected ear. Then, the patient is quickly laid back so their head hangs just over the edge of the table. This often brings on the spinning feeling and eye movements called nystagmus. Once the dizziness passes, the head is slowly turned to the other side while the patient stays lying down. Next, the patient rolls onto their side so their head faces the floor. Finally, they sit up again.

These steps help the crystals move out of the posterior canal and back into the utricle. Many studies show that the Epley maneuver works well, often stopping symptoms after just one or two treatments.

If BPPV affects the horizontal canal, symptoms can be stronger and often happen when turning the head from side to side while lying down. The main treatment for this type is the Lempert maneuver, also known as the barbecue roll.

For this maneuver, the patient starts by lying on their back with their head turned toward the affected ear. The therapist then helps the patient roll in 90-degree steps away from the affected side. The patient keeps rolling in stages until they have turned all the way around.

Each position is held for about 15 to 30 seconds or until the dizziness fades. The patient moves from lying on their back, to their unaffected side, then face down, and finally sits up. This slow rolling helps gravity move the crystals out of the horizontal canal and back into the utricle.

Anterior canal BPPV is the rarest type of positional vertigo, but it can still cause strong symptoms. Since the anterior canal is positioned differently, it needs a special treatment called the deep head hanging maneuver, or Yacovino maneuver.

For this maneuver, the patient starts sitting up. The therapist quickly lowers them backward so their head hangs far below the edge of the table. This position lets gravity move the crystals away from sensitive parts of the canal. After a short hold, the patient’s head is brought forward with the chin tucked, still lying down. Finally, the patient sits up again.

The purpose of this maneuver is to move the crystals out of the anterior canal and back to the utricle, stopping the abnormal signals that cause vertigo.

Before starting any treatment, healthcare professionals usually do tests like the Dix-Hallpike or supine roll test to find out which canal is affected. These tests cause certain eye movements that help pinpoint where the crystals are.

Repositioning maneuvers are the main treatment for BPPV and work very well. Many people feel better right after treatment, though some may need more than one session. Sometimes, patients get home exercises to help prevent the problem from coming back.

Positional vertigo, or BPPV, happens when small calcium crystals move into a semicircular canal in the inner ear and upset the balance system. This causes short but strong spinning dizziness when you move your head. The good news is that BPPV can almost always be treated with special maneuvers for each canal. The Epley maneuver is used for the posterior canal, the Lempert (barbecue roll) for the horizontal canal, and the deep head hanging maneuver for the anterior canal. With the right diagnosis and treatment, most people feel much better and can get back to their normal lives free of ongoing dizziness.