Recovery of BPPV: A Case Presentation

Imagine feeling dizzy, nauseous, and disoriented, not just once in a while, but on and off for five long years. That was the reality for a 49-year-old woman who had been battling vertigo—a condition that leaves you feeling like the world is spinning even when you're standing still. Over the past 12 months, her symptoms got much worse, making it hard for her to focus at work and in social situations. Despite taking medication for the nausea, nothing seemed to fix the problem.

Blood tests and brain scans didn’t reveal any apparent issues, leaving her frustrated and unable to find relief. As a manager with a job that required frequent travel, her worsening vertigo began affecting both her work performance and her day-to-day life. She needed a solution.

What is Vertigo?


Vertigo isn’t just “feeling dizzy”—it’s more complicated than that. It can have many causes, and determining the right one is vital to treatment. In this patient’s case, she had a condition called Benign Paroxysmal Positional Vertigo (BPPV), a type of vertigo caused by issues in the inner ear. Specifically, she had a problem with a part of her inner ear known as the saccule, which helps control balance.

The saccule malfunctions can make you feel dizzy, off-balance, and nauseous, especially when you move your head in specific directions. 

The Assessment: What Did We Find?


After a detailed examination, we found some important clues about her condition:
1. She reported mild dizziness that seriously impacted her life (scored 50% on the Dizziness Handicap Inventory).
2. Her balance confidence was also shallow (Modified Falls Efficiency Score of 50%).
3. Her eye movements weren’t as smooth as they should be, especially when tracking objects.
4. When tested for Dynamic Visual Acuity (DVA), she struggled with vision during vertical head movements.
5. Her walking pattern was unsteady, especially when she moved her head up and down.
6. A particular test (Dix-Hallpike) confirmed her diagnosis of BPPV, showing both nystagmus (involuntary eye movements) and nausea.

Our Goals for Treatment:
- Reduce her dizziness and vertigo symptoms.
- Improve her balance and confidence while moving.
- Help her adapt to everyday life without feeling held back by her condition.

The Treatment: Vestibular Rehabilitation Therapy (VRT)


To address her vertigo, we used Vestibular Rehabilitation Therapy (VRT), a specialised exercise program designed to retrain the brain and inner ear to work together better. Over 12 weeks, the patient worked on exercises that included:
- Head and eye movements that helped her brain adjust to the sensations that triggered her dizziness.
- Balance training to improve her coordination and stability.
- Gradual exposure to movements that once made her feel dizzy so her body could get used to them and reduce her symptoms.

VRT is a highly effective and safe way to treat vertigo because it helps the body adapt naturally, reducing the frequency and intensity of dizzy spells.

The Results: A Full Recovery


After 12 weeks of therapy, the patient’s transformation was remarkable. She no longer experienced vertigo or nausea and felt more confident in her daily movements. Her balance and vision tests improved dramatically, and she could return to her job and social life without any lingering symptoms.

Her success story is an excellent example of how targeted therapy like VRT can help people reclaim their lives from the grip of vertigo. She now enjoys full mobility, and her quality of life has improved in every aspect.

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Recovery of BPPV: A Case Presentation