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Helpful Resources

We know that struggling with dizziness, vertigo, imbalance, or any sort of disequilibrium can be incredibly distressing, especially when you don’t feel like you’re getting any answers as to what might be causing it, but you are not alone

You Are Not Alone

Dizziness and balance disorders are unfortunately very common, but there are some excellent resources available to help you understand more about what you are experiencing and connect with others who have been down the same path.

Of course, getting a comprehensive neurovestibular assessment is key to determining exactly what may be causing your symptoms and finding out what can be done about it, but in the meantime, and even after you’ve received a diagnosis, the following two organizations are tremendous sources of information, support, and advocacy for anyone experiencing balance & dizziness-related problems:

BDC

Balance and Dizziness Canada https://balanceanddizziness.org

Vestibular Disorders Association https://vestibular.org

From Our Blog

BPPV Self Assessment Tool

A lof of people inquire about booking our “BPPV Assess & Treat” appointment because it is so much shorter and less expensive than a comprehensive assessment. The reason you aren’t able to book it online is that there seems to be a lot of confusion about what BPPV is, and what it is not. Many people have been told that they have BPPV when a few simple screening questions would have determined that they most definitely do not. We are more than happy to assess and treat BPPV. In fact, we love it! It is incredibly rewarding to be able to immediately resolve something that is so debilitating with a few simple maneuvers. Unfortunately, not all dizziness is a result of BPPV, and there’s no point in wasting your time and money on an unnecessary additional appointment when it may have been obvious from the start that your symptoms were not consistent with BPPV. We cannot deduct the cost of a BPPV Assess & Treat from a subsequent comprehensive assessment if you decide to book it just because it is shorter, even though your symptoms are not consistent with it. We still have to book the same amount of clinic time for a comprehensive assessment if that’s ultimately what you end up needing, whether you’ve had a previous BPPV assessment or not, so it may end up costing you more in the long run. Please don’t take that to mean we don’t want to see you if you think you have BPPV – we absolutely do. We just really want to clarify what seems to be a lot of confusion surrounding BPPV. Please read the following information, and if it does in fact seem that you may have BPPV, please give us a call or send us an email letting us know you’ve read the BPPV screening information and we will be more than happy to book you in immediately. Thank you kindly for your understanding. 

Benign Paroxysmal Positional Vertigo (BPPV) is a common peripheral vestibular condition that most people have heard referred to as something along the lines of “loose crystals” in the ears. While BPPV is certainly common, it is by no means the only source of dizziness and vertigo symptoms and is very frequently erroneously diagnosed. I.e. people are often immediately diagnosed with BPPV as soon as they report any sort of dizziness/vertigo symptoms at all, or mistakenly self-diagnose because it’s the first thing that comes up in a Google search of “vertigo” or “dizzy” symptoms. If you do indeed have BPPV, that’s actually good news! BPPV is the one vestibular disorder that has an immediate corrective solution. Once we determine exactly where the “loose crystals” are located, we can physically manipulate them back into their correct location with specific maneuvers. That’s why we have the option of a much shorter duration “BPPV Assess & Treat” appointment. Before booking that though, we need to figure out if you are likely experiencing BPPV or not.

BPPV has 3 very distinct characteristics:

  1. It is positionally provoked: It only occurs in response to specific changes in head position, most commonly rear head pitch/looking up/laying back with your head turned to one side, or rolling horizontally from one side to the other. Deep forward bending/forward head pitch may also provoke a response at times. If you experience spontaneous vertigo with no change in head position at all (ex. sitting or standing still and upright) it is NOT BPPV.
  2. It causes true vertigo: True vertigo, as we define it clinically, is the hallucination of movement. BPPV causes severe rotational vertigo, typically a violent spinning or tumbling sensation (it is NOT subtle). There are endless forms of what we call “non-vertiginous” dizziness (ex. light-headedness, unsteadiness, imbalance, disequilibrium, wooziness, brain fog, etc.) but those are not considered true vertigo. You may feel non-vertiginous dizziness after having had a true vertigo attack, but if you didn’t experience any intense rotational spinning/tumbling in the first place, you do NOT have BPPV.   
  3. It is short duration: The acute vertigo doesn’t last long (usually less than 30 sec). BPPV is caused by the physical movement of inner-ear “crystals” in response to a specific change in head position. It is governed by gravity. The vertigo can only occur as long as the “crystals” are physically moving – once they stop, so does the vertigo. It typically takes less than 30 seconds for the crystals to settle if you remain still. It is not physiologically possible for BPPV to cause prolonged/sustained acute vertigo lasting several hours or days. If you have/had prolonged acute vertigo lasting hours without stopping, it is NOT BPPV.  It is possible to have multiple episodes, which occur each time you move in a specific way, but each one should not last any longer than a minute if it is BPPV. There is a less common variant of BPPV that can produce more prolonged vertigo lasting up to 1 min, but rarely any longer than that.

Additional Information:

BPPV can also occur as a secondary result of something else that is going on in your inner-ears. If you have all the symptoms of BPPV but are experiencing additional symptoms, you may need more thorough examination, and sometimes even urgent medical care. Some things to look out for are:

    • Sudden hearing loss in one or both ears (BPPV does not cause hearing loss – sudden loss of hearing is an emergency and should be assessed immediately – depending on the cause, there may be a very narrow window in which pharmacologic intervention can prevent permanent loss)
    • Aural fullness: If one of your ears suddenly felt like it became very plugged or full around the same time as your vertigo, this also needs to be assessed more urgently and thoroughly. BPPV does not cause pressure/fullness in your ear.
    • Recurrent BPPV: BPPV is something that many people will likely experience once or twice in their lifetime. Once treated with appropriate repositioning maneuvers, it usually doesn’t recur very frequently (if ever), unless there is some underlying risk factor or condition that is causing it. If you suffer from chronic recurrence of BPPV episodes even after you get it resolved with repositioning maneuvers each time, it might be time to have a more thorough assessment. 
    • Always be aware of signs of stroke (F.A.S.T): 
      • Face drooping (especially on one side)
      • Arm weakness (raise arms. is one side weak?)
      • Speech (Is it slurred/difficult to speak?)
      • Time to call 911

If you would like to read some more detailed information on BPPV, here are two excellent articles: 

Common Disorders (Other than BPPV)

Here is a list of some of the most common disorders we see, with links to some excellent articles from Balance and Dizziness Canada, and VeDA. Note that some are peripheral/ear disorders, some are central/neurologic disorders, and some are a combination of both, or may not be vestibular at all (ex. cervicogenic dizziness). This list is by no means exhaustive. The fact is that dizziness and imbalance symptoms can be caused by a vast number of different things, which is why thorough testing is so important.