Geoff Blackburn had no idea what was happening to him. To the retired 64-year-old in Ladysmith, B.C., basic activities—lying down to sleep, getting up, bending down to tie his shoe or moving his head rapidly—caused the room to spin for about five seconds. The dizziness became more frequent, but a neurologist found nothing seriously wrong with Blackburn and sent him to a therapist specializing in balance disorders.
After a few tests, therapist Lorelei Lew told him he had “benign paroxysmal positional vertigo,” or BPPV, dizziness that makes you feel that the room is spinning, or that you are spinning. Although the treatment doesn’t always quell symptoms permanently, it usually is simple: With Blackburn lying down, the therapist tilted his head to one side and moved it in a series of motions. “It was magic,” says Blackburn. The vertigo went away and hasn’t returned.
Balance, controlled in part by the vestibular system, depends on the inner ears, which have three semicircular canals to detect the rotation of the head. In addition, receptors containing calcium-carbonate crystals help the body detect gravity and changes in motion such as stopping and starting. Sometimes the crystals can become dislodged and can enter one of the semicircular canals, playing havoc with one’s sense of balance and causing BPPV. The disorder is usually the result of aging, trauma to the head or an infection of some kind.
An episode of BPPV is triggered by a particular motion and usually lasts ten to 15 seconds. Episodes also cause nystagmus—involuntary movement or jitteriness of the eyes—which is key to the diagnosis of BPPV.
Dr. Lorne Parnes, a professor in the Department of Otolaryngology at the University of Western Ontario, says repositioning manoeuvres are highly successful with BPPV. “With one manoeuvre, you can correct the condition 80 percent of the time; with three treatments, you alleviate it in 95 percent of patients.”
But for some BPPV sufferers, as well as for those with other non-life-threatening balance disorders, diagnosis and treatment—or both—may not be so straightforward or low-tech. While BPPV is the most common cause of balance disorder, with an estimated 300,000 new cases diagnosed in Canada each year, dizziness in one form or another affects approximately 50 percent of adult Canadians at some time in their lives. But there is good news for these thousands of sufferers: Treatment options—old, new and still being researched—are available.
But for 48-year-old Randal Roberts of Edmonton, no amount of repositioning manoeuvres seemed to help; his BPPV attacks were recurring. The episodes started 20 years ago, following a bad car accident. They were brief, but for a half day afterwards, Roberts would feel disoriented and woozy. “I had to read something two or three times to understand what I was reading,” he says.