Crystals in the ear are just a fancy term for the calcium carbonate nodules that generally reside in the middle ear. These ‘crystals’ move in response to gravity, thus are motion-sensitive. When they reside in the middle ear, they don’t cause any problems with the way a person moves their head in various directions.
However, when they mistakenly get dislodged in the inner ear, they move with any changes in the position of the head, thus activating the tiny hair on the surface of the inner ear. This causes the inner ear to send conflicting signals & messages to the brain regarding the body’s position in space.
The brain receives balance information from three different organ systems; the vestibular system in the inner ear, the eyes, & the legs. It then combines & processes the information received from each of these systems into a single, common decision of movement.
However, when even one of these systems doesn’t function correctly & sends out conflicting signals, the brain is confused & gives out mixed signals & misfires in a lot of brain centers & systems. This leads to dizziness, loss of coordination, disbalance, & nausea, among other symptoms like migraines, trouble walking straight, etc.
These crystals, when they get dislodged in the inner ear, cause a type of vertigo called BPPV, also known as Benign Paroxysmal Positional Vertigo(BPPV).
Benign Paroxysmal Positional Vertigo is a type of vertigo that causes sudden bouts of dizziness, headaches of migraine intensity, nausea, motion sickness, & trouble keeping a straight gait. BPPV causes include an infection, an injury, trauma, diabetes, migraine, osteoporosis, leading a sedentary lifestyle & being bedridden for a long time. Age is also a natural cause of BPPV. In some cases, the exact cause of BPPV is not known, & it may appear suddenly.
BPPV symptoms are different for every single individual. However, there are a few that are common for all patients. These common BPPV symptoms include:
- Sudden dizziness
- Motion sickness
- Headaches, sometimes of migraine intensity
- Nystagmus, an abnormal movement of the eyes in a jerking motion
Some people also experience Tinnitus along with dizziness, nausea, & vomiting. This is more common in patients suffering from an inner ear disorder called Meniere’s Disease, & infections like Vestibular Neuritis &/or labyrinthitis.
BPP Vertigo treatment:
BPPV treatment often includes a cocktail of medicines, Vertigo exercises, & home remedies. Often your doctor will prescribe you a certain type of exercise called the canalith repositioning procedure(CRP) to displace the calcium crystals from the inner ear back into their original position in the middle ear.
Canalith Respositione Maneuver is a BPPV-specific exercise that helps the displaced calcium crystals in the inner ear move back into their original position in the middle ear. It does so with a set of head movements that causes the crystals to move into a part of the ear where they can either be dissolved or get reattached.
Anybody experiencing BPPV can undergo canalith repositioning maneuver as part of their BPPV treatment regime.
Who can perform the Canalith Repositioning maneuver?
CRP is only used for BPPV treatment. It doesn’t work for any other kind of vertigo, which includes:
- Problems with brain structure
- Migraine headache induced vertigo
- Vestibular neuritis, an ear infection
- Meniere’s Disease, an inner ear disorder that is caused by an abnormal amount of fluid inside the ear, causes tinnitus along with other vertigo symptoms
- Orthostatic Hypotension, which causes low blood pressure when a person stands up
- Panic attacks & anxiety induced vertigo & dizziness
Before performing Canalith Repositioning Maneuver:
Before you perform the Canalith Repositioning Maneuver, your doctor will perform a test called the Dix-Hallpike maneuver to figure out if you have BPPV or not. The Dix-hallpike maneuver is an easy test that you can perform yourself to see if you have BPPV or not. For this, you have to lie down on a table or any flat surface in such a way that the inner ear crystals(if any are present), produce dizziness & nystagmus upon being activated by head movements.
The Dix-Hallpike test can also give an idea to the doctor about which ear BPPV you have, as you will only start feeling dizzy when you tip your head in a certain direction. This will help your doctor figure out the best canalith repositioning maneuver exercise for you, either the Epley Maneuver or the Semont-Liberatory maneuver.
How is the Canalith Repositioning Maneuver performed?
The Epley Maneuver is performed in a series of steps that helps move the calcium crystals back into the middle ear where they don’t cause any problems. To perform the Epley Maneuver efficiently, follow the steps below.
These steps mentioned below are for when you have left-ear BPPV.
- Sit on the edge of your bed & turn your head 45 degrees to the left. Place a pillow under your shoulders in such a way that when you lie down, your shoulders rest on the pillow and not your head.
- Now quickly lie down on your back with your head lying on the bed at a 45-degree angle. The pillow should still be under your shoulders.
- Turn your head at a right angle without raising your head. Wait 30 seconds at this point.
- Now turn your head & your entire body to the right, in such a way that you are facing the floor. Wait 30 seconds in this position.
- Now sit up slowly, remaining on the bed for a few minutes.
- Wait at least 15 minutes before resuming everyday activities.
For right-ear BPPV, simply reverse the direction of the steps. Turn your head first to the right, lie down, then turn your head & body towards the left at a right angle.
Try to perform the Epley Maneuver vertigo exercises thrice every day, five times in repetition, until your vertigo symptoms show signs of improvement. TheSemontManeuveralso called the Semont-Liberatory maneuver, is another popular canalith repositioning maneuver used in BPPV treatment.
It’s often prescribed to patients of BPPV to help them get relief from their symptoms. The steps mentioned below are for when you have left-ear BPPV.
- Sit on the edge of your bed & turn your head 45 degrees to the right.
- Quickly lie on your left side, & stay there for 30 seconds.
- Now quickly move to lie on the opposite side of your bed, without changing the direction of your head. Keep it at a 45-degree angle & lie down for about 30 seconds. Ensure that you look towards the floor.
- Wait for at least 15 minutes before returning to everyday activities.
For right-ear BPPV, simply reverse the steps in the right direction. Repeat these steps about thrice every day until your symptoms show signs of improvement.