Benign paroxysmal positional vertigo (BPPV) most commonly causes vertigo-like symptoms. This happens because of three semicircular canals in the bony labyrinth. Each of these canals contains a fluid, which is called endolymph. This fluid bends in the tiny cilia which lines the interior of the semicircular canals because of head movement. The endolymph is dense, which results in the residual spinning symptoms for seconds after head movement.
Cilia stimulation, input from the eyes, and proprioception from the cervical spine combine to determine balance. With this being said, dysfunction of any of these three can have an affect on your balance.
The Dix-Hallpike Maneuver can challenge all three of these simultaneously. This is a maneuver used by a doctor of chiropractic to test the posterior semicircular canal. The test has a specificity of 83% and a sensitivity of 52% for BPPV arising from the posterior semicircular canal.
How do you treat BPPV, you may ask?
Well, your doctor of chiropractic can perform the Epeley maneuver, which has an effectiveness ranging from 78 to 95 percent. There are also some at home exercises which you can perform. One of the most effective and popular exercises is the Foster Half-Somersault Maneuver. It starts with the patient kneeling with their buttocks on their heels. The patient tips their head straight up to look at the ceiling and holds this position until after any dizziness has faded for several seconds. Next, the patient quickly bends their head and body forward to lightly rest the top of their head on the floor slightly in front of their knees.
Their hands should be on the floor in front of their knees to prevent excessive head and neck loading. The patient turns their head toward the affected ear and holds this position until after any dizziness has faded for several seconds. Next, while maintaining head rotation, the patient raises their head to the level of their spine. The patient holds this position until after any dizziness has faded for several seconds, then quickly returns to an upright kneeling position.
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