Auditory and Vestibular Disorders

Question 1

What is Benign Paroxysmal Positional Vertigo?

Answer 1

A peripheral disorder where the otoliths (carbon crystals) from the utricle, detach from the maculae and float around the semi-circular canals.

Question 2

Describe the pathology of BPPV?

Answer 2

Otoliths are not supposed to be found in the canals so when floating in the canals, will induce a bigger endolymph flow when the head moves (the crystals will carry more liquid). Movement of the head processed by brain as bigger and faster than it is in reality. This will cause vertigo attacks every time the head moves quickly, especially when lying down or standing up.

Question 3

Why is BPPV intermittent?

Answer 3

The attacks are short as end when endolymph settles (less than a min). Recurrent as happens every time the person changes the head position quickly (lying down or getting up from bed).

Question 4

Do symptoms occur when still?

Answer 4

When the head is still, usually there are no vertigo symptoms, but some patients can refer feeling a bit unstable or lightheaded when walking

Question 5

When does BPPV continue till?

Answer 5

The disorder will continue until the crystals are taken back to the utricle with repositioning manoeuvres such as Epley or Semont.

Question 6

What in history supports diagnosis of BPPV?

Answer 6

1. Sudden and intermittent vertigo crisis
2. Short lasting (minutes) spinning vertigo.
3. Triggered when getting up and lying down.
4. No symptoms when standing still
5. No new hearing symptom accompanying the vestibular event, the hearing problems are clearly coming from previous time.

Question 7

Can hearing problems and dizziness be related?

Answer 7

In many conditions with inner ear dysfunction, two can be related. However, as BPPV only affects semi-circular canals where crystals were floating around, hearing would not be affected.