by Kellie Pokrifka
If you are experiencing issues with dizziness and imbalance after brain injury, you may have been told to consider BPPV. But what is BPPV, besides a tongue twister that is almost impossible to pronounce?
BPPV stands for Benign Paroxysmal Positional Vertigo. (Yes, somehow the full term is even more difficult to pronounce than the acronym.) BPPV is the most common deficit to the vestibular system after trauma such as brain injury. It is a constant feeling of movement, even when you’re not moving, that occurs due to the crystals in your inner ears.
What are these inner ear crystals? Made up of calcium carbonate, otoconia, as the crystals are called, e normally reside within a gel-like substance. When the gel moves, such as when you tip your head back, neurotransmitters send an alert to your brain that you are moving.
The physical trauma of a TBI can cause the crystals to dislodge from their normal position and deposit themselves in semicircular canals within the inner ear. Since they are out of place, they can no longer send appropriate signals to the brain. They send “false alarms,” convincing the brain that there is movement even when you are perfectly still.
The signals from your vision and musculoskeletal system, though, are telling your brain that you are not moving. The contradicting signals confuse your brain, which reacts by telling you that something is wrong by giving you that dreadful sense of vertigo.
In most cases, vertigo typically lasts less than one minute, although some cases will unfortunately persist until the head is repositioned. BPPV is only affected by movement, so there is no continual sense of dizziness. It will not affect headache, movement coordination, hearing, or fainting.
Luckily, BPPV is effectively treated. Several protocols can be utilized such as the Epley Maneuver, as well as similar procedures like the Semont Maneuver, the Foster Maneuver, and the Brandt-Daroff Exercise. A physical therapist trained in vestibular rehabilitation may be your best instructor about these adjustments. Be sure to consult your doctor(s) before making any changes to your recovery plan.
If you are experiencing BPPV, or other forms of vertigo or dizziness, you should address the issue as soon as possible. These symptoms can dramatically affect your balance, which can be incredibly dangerous. Individuals who reported dizziness are 12 times more likely to fall. Forty percent of all traumatic brain injuries in the US result from falls. On top of that, after sustaining an initial brain injury, a person is more susceptible to additional TBI. Impaired balance is clearly not an issue to be taken lightly. Consult your doctor as soon as possible.
Kellie is a TBI survivor and works as an intermediary between the experts and the patients with brain injuries.