Signs of benign paroxysmal positional dizziness

1 What is RPGP?Benign paroxysmal positional dizziness, or DPPH, is an ailment that develops as a result of injuries to the inner ear. The disease is characterized by short-term phases of vertigo of systemic type. Attacks occur when changing the position of the trunk, turning the head, moving.

DPPG accompanies symptoms that are characteristic of other diseases, which increases the risk of misdiagnosis. But there are a number of features that make it possible to distinguish RPPG. These include the following:

1. Paroxysmal flow. Dizziness does not last all the time. Each attack begins suddenly, and without any justified reasons. The dizziness phase ends as unexpectedly and independently.
2. The duration of the attack. It can be different, but usually lasts no longer than a few minutes.
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3. Vegetative symptoms during an attack. A person with a diagnosis of PPHD may look pale, complain of nausea, there is a feeling of fever or increased sweating.
4. General health. If the head is not spinning, the person feels well.
5. Recovery period. Usually, the improvement occurs 1 month after the beginning of the treatment of the disease, that is, the body recovers fairly quickly.

Disease usually does not pose a threat to human health or life, but significantly reduces their quality. If the patient ignores the disease and does not treat it, it can lead to undesirable consequences. So, doctors warn that during a sharp attack of dizziness a person can get injured( for example, when falling), get or become the initiator of a car accident or an industrial accident.

2 Classification of

Benign paroxysmal positional dizziness is divided into several forms. The first classification - according to the mechanism of development:

1. Canalolithiasis. It develops due to the free movement of the otoliths in the endolymph, which causes irritation of the receptors with any change in the position of the head.
2. Kupulolithiasis. This form is diagnosed by fixing the otoliths to some part of the cupula, as a result of which constant irritation of the receptors occurs when the person changes the position of the head.

The following classification - depending on which ear is affected:

• right-sided dizziness;
• left-sided dizziness.

The structure of the inner ear is made up of semicircular canals( there are 3 of them), which are responsible for the balance. Depending on which channel is affected, distinguish:

• dizziness with a lesion of the posterior canal( it is diagnosed in the absolute majority of cases);
• dizziness with lesion of lateral, or horizontal, canal( diagnosed in no more than 5% of patients);
• dizziness with anterior canal lesion( diagnosed in no more than 1% of patients).

The disease usually begins suddenly, and similarly, there can come a remission, and without any intervention from the doctors. But the disease can again make itself felt even after several years.

3 Clinical picture of

This disease is accompanied by characteristic symptoms. Most often, patients complain of the following:

• increased dizziness with sharp turns of the head, regardless of the position of the body;
• is a one-sided disease;
• feeling of nausea, vomiting;
• a feeling of constant wiggling, especially during movement, with the head tipping back and in the prone position.

The attack of dizziness usually lasts from a few seconds to 1 minute, but even during the day after an attack a person "departs" from it: a dizziness of a non-systemic nature, a feeling of weakness, instability - these are the main symptoms that patients complain about.

In this case, there are a number of signs that are characteristic of other types of dizziness, but not accompanying RVPG.They help to distinguish the form of dizziness. So, with BPAH, there is no sensation of noise and ringing in the ears, deafness or hearing loss, intense headache.

4 Causes of the development of the disease

The cause of development of DPAH is always the same - the pathology of the structures of the peripheral vestibular apparatus.

The vestibular apparatus is part of the inner ear, which explains this relationship. But the pathology itself can lead to different factors. Doctors say that most often they can not be identified. In other cases, the reasons may be as follows:

• traumatic brain injury;
• infectious diseases of the inner ear of a viral nature;
• drug therapy, in particular, the toxic effects of antibacterial drugs on the ear( eg, Gentamicin);
• operative intervention on the inner ear;
• age changes, namely, the degeneration of otoliths due to natural aging of the organism;
• Infectious-inflammatory processes in canals( labyrinthite);
• Ménière's disease;
• chronic migraines due to dystonia or spasms of the arteries.

Medical statistics say that with age, the risk of developing ailment increases, while among the children of this diagnosis, this diagnosis is extremely rare.

5 Methods of treatment

Before making a diagnosis, it is necessary to conduct a patient examination. The doctor collects an anamnesis, directs the patient for diagnosis. The most important method, allowing to make a diagnosis, is a sample of the vertigo of Dix-Hallpike. By quickly changing the position of the trunk and the patient's head, the doctor observes the changes that occur. In particular, the doctor is interested in the appearance of nystagmus. With rotational nystagmus, the sample is evaluated as positive, that is, the diagnosis of "benign positional vertigo" is confirmed. The affected one is the ear, which, when a nystagmus is found, is located at the bottom with the head turned.

Methods of treatment are divided into several groups:

1. Medication. The goal is to accelerate vestibular rehabilitation and improve the balance function. The doctor may prescribe drugs of the vestibulospressor group, angioprotectors, nootropics and vitamins.
2. Therapeutic exercises. The goal is the training of the vestibular apparatus, which solves the problems arising during movements and inclinations of the head.
3. Operative intervention. The goal is to fence the semicircular canal.

The operation is only shown when none of the conservative methods yielded the desired result. Usually, non-surgical methods are effective, but if the disease is severe and persistent, drug therapy and exercise may be impotent.

6 Exercises for dizziness

There are a number of techniques that can help to strengthen the vestibular apparatus and relieve a person from dizziness and other unpleasant symptoms. One such was created by John Epley. It is called the Epley maneuver. The patient can do everything at home.

Exercises should be performed on the floor or the couch, on one edge of which you must first put a small pillow. The basis of the technique is the following exercises:

1. Starting position: sitting on the couch or floor, back straight. Rotate the head 45 ° in the direction of the affected ear.
2. Sharply change the position - lie on your back so that the prepared pillow is under your neck. The head should hang over the edge of the pillow. To sustain from 2 to 3 minutes.
3. Turn your head sharply toward the uninspired ear. Then perform an additional turn of the head by 90 ° along with the trunk. That is, the patient assumes a lying position on his side with his face turned to the floor. To sustain from 2 to 3 minutes.
4. Accept the initial sitting position on the couch or floor.

It should be noted that in no way can these exercises be performed without the doctor's testimony and the patient's preliminary training in the correct implementation of them. Effective in RPPG maneuvers can harm with dizziness of another origin.