![]() While the saccule also contains otoconia, they are not able to migrate into the canal system. ![]() Ear rocks are small crystals of calcium carbonate derived from a structure in the ear called the "utricle" (figure1 ). This debris can be thought of as "ear rocks", although the formal name is "otoconia". The problem with taking the medication is that it does not address the cause of the problem, and it delays your brain’s ability to compensate and recover.In Benign Paroxysmal Positional Vertigo (BPPV) dizziness is generally thought to be due to debris which has collected within a part of the inner ear. Many times, patients go to the emergency room or urgent care setting with vertigo that is BPPV, but they are given a vestibular suppressant like meclizine or benzodiazepene instead of being offered CRP. The surgery is very effective with minimal risks. Rarely, people need surgery to close off the posterior canal because there are so many rocks or so much “sludge” that the CRP treatments do not work. Most people are “cured” after one or two treatments, but some may need additional “repositioning” treatments. The success rates for these office treatments, which take only several minutes, are very high. These are done either in your doctor’s office or by the physical therapist, and involve putting you into a position that causes vertigo, allowing it to pass, and then turning your head carefully to move those tiny crystals in your inner ear to a portion of the inner ear where they won’t do any harm. They may be called Epley or Semont maneuvers as well. These treatments are office procedures called Canalith Repositioning Procedures, or CRP. The treatment for BPPV involves moving those misplaced rocks or crystals from the active portion of the inner ear to the inactive portion of the inner ear, where they won’t cause dizziness. ![]() Once the side of the vertigo is identified, the doctor may either immediately offer you a treatment, or may refer you to a specialist (otolaryngologist or vestibular physical therapist) who can offer you that treatment. Another test that looks for BPPV of the horizontal (and not posterior) balance canal is the supine roll test, where you are already lying on your back and your head is moved from side to side. You will be seated on a flat surface and then brought down into positions that can provoke the vertigo experienced in BPPV. After a thorough examination of your ears, nose, throat, and neck, the doctor will perform a test on you that is called a Dix-Hallpike Maneuver. Your doctor or other healthcare professional will ask you questions about your dizziness and vertigo, and, with careful listening, can often distinguish between BPPV and other types of dizziness. It can also occur a long time after another inner ear problem such as labyrinthitis or Ménière’s disease. It can also occur after any type of even minor head trauma, even as small as a violent sneeze or hitting your head on a cabinet, and with major head trauma or after a concussion. It is commonly seen in the elderly without an underlying cause identified. If you stay in that position and open your eyes, within a few seconds the brain figures it out and you stop “whirling.” But this is a scary feeling, so most people with BPPV don’t stay in that position or open their eyes.īPPV can occur spontaneously, that is, without a real cause. So, when you turn your head into those certain positions, the rock pushes on the canal, and the brain thinks you are whirling around. This usually affects the posterior of the three balance canals on that side, because that’s the lowest one and the rock follows the rules of gravity. In BPPV, a rock or two gets dislodged from the organ and falls towards the balance canals. The gravity organs have tiny calcium carbonate crystals in them, which are often referred to as “rocks.” In the inner ear, we have balance canals that detect movement, and balance organs that detect gravity. The way we maintain balance when we move about is by the complex interactions of both inner ears, the eyes, the muscles down your back, and soles of the feet, and how all of these get processed in the brain. Vertigo-You feel like you are spinning, or the world around you is spinning. Positional-Certain head positions or movements can trigger a spell. ![]() Paroxysmal (par-ek-siz-muhl)-It comes in sudden, short spells. BPPV is a specific diagnosis and each word describes the condition:īenign-It is not life-threatening, even though the symptoms can be very intense and upsetting. It can occur just once or twice, or it can last days or weeks, or, rarely, for months. BPPV is the most common inner ear problem and cause of vertigo, or false sense of spinning. If so, there’s a good chance you have benign paroxysmal positional vertigo, or BPPV (commonly known as “having rocks in the head”). ![]()
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