We were recently asked, “Why does BPPV go away and come back?”. To understand the treatment and natural history of BPPV it helps to understand how it happens in the first place.
Lets imagine that the inner ear is akin to a tiny snow globe inside the head. In a healthy person the snow inside this globe is actually stuck down but with age the snow comes loose and begins to fly around when disturbed. Now lets imagine there is a house inside the snow globe. Inside the house are the very sensitive balance organs of the inner ear. There are, of course, windows in the house and sometimes flying snow comes in through those windows. When that happens you get BPPV.
Every time the snow globe is disturbed, by rolling over or looking up, the snow inside the house causes the balance organs to be confused and the sensation of vertigo results. The snow can fall out of the windows of the house as well but this only happens sometimes when you are in just the right position. The treatment maneuver for BPPV carefully guides these particles out. You can have your doctor do the maneuver or do it yourself with a BPPV treatment device.
Without treatment BPPV often lasts 2 weeks until the particles inside the house (which is actually called the posterior semi-circular canal) fall out or somehow breakup. However, more snow can come in and usually does in about 60% of people.
Clearwater Clinical says:
Thanks for your comments. Can you clarify what you mean by “dizzy”, do you mean spinning dizziness or just off balance? It is common to have an “off balance” feeling after a correct BPPV treatment maneuver which lasts weeks. However, if you still get dizzy with turning when laying down then you may not have complete resolution and could benefit from a second manevuer. You may also have a different diagnosis. It may be worth clarifying with you own doctor. Depending on what you do for you work don’t put yourself at risk if you feel dizzy (ie no ladders etc)
7th February 2013 at 6:12 am
devona says:
Bart, thanks for the info. Did u go to work w/these symptoms? I’ve been going though this for 2 wks & 3 days I feel better at times when I’m just sitting Watchn tv then I get up & there if goes my doctor did the movements it help a little bit but I’m still dizzy. Help…
6th February 2013 at 11:15 pm
admin says:
That’s a very interesting situation and not all that uncommon. The answer is yes it is possible to have both. Unfortunately BPPV is a side effect of any injury to the ear. That injury may be as simple as ongoing age, but also can be due to head trauma, infections or other ear diseases like Meniere’s. Vertigo and dizziness that lasts longer than a minute or so is not BPPV. Other possibilities include a “Fistula” which causes hearing loss and vertigo intermittently. There are treatments for all of these which in some cases include surgery or injections of medication into the ear. Vertigo can be a difficult problem so it is important to seek local diagnosis and treatment. If your local ENT can’t help then find a “neurotologist” – who is a specialized ENT dealing with the inner ear. Regards.
2nd August 2011 at 6:01 am
Bart Wiley says:
Can bppv last for a year, I’m tryn to figure out if I have meniers it bppv it seems like I have some symptoms of both , I feel pressure in my head, but on other hand my eyes twitch or bounce when ever I put my head in a onward position it’s weird I have attacks that come about every 5 days I’ll be dizzy for about 3 days straight both some realy bad attacks in those three days then it will leave an come right back again , it’s been doing this for about a year now , if u have any suggestion about my diagnosis I would be greatfull my ENT can’t seem to help me out
26th July 2011 at 2:17 am