BPPV vs Vestibular Neuritis

How to tell the difference between BPPV (Benign Paroxysmal Positional Vertigo) and Vestibular neuritis so you can recover more quickly
#bppv #vertigo #vestibularneuritis



If you have debilitating vertigo it’s important to know what the cause is so you can recover as quickly as possible. I’m Dr AJ Ludlow and in this video you’ll learn how to tell the difference between BPPV and vestibular neuritis. Make sure to watch until the end because we’ll cover what to do to recover from each condition.

First, we’ll cover vestibular neuritis. This condition is caused when a virus causes damage to the vestibular nerve. It’s possibly a form of the herpes virus (which also causes cold sores, chickenpox, and shingles) but has also been found to be associated with the influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr viruses. The vestibular nerve brings information to the brain from our inner ear to help us maintain balance. The infection causes inflammation and swelling of the nerve which distorts the information coming into the brain causing vertigo. About 50% of people with vestibular neuritis will have viral symptoms, kind of like a head cold, before the vertigo sets in. When vestibular neuritis starts, it is a sudden onset of dizziness, nausea, vomiting and a feeling of being off balance that lasts from 1 to about 3 days. Over the course of a week the dizziness will gradually decrease. Then over the next few months the symptoms will continue to slowly decrease. It usually doesn’t cause further intense episodes of dizziness after it starts to calm down. It doesn’t affect your hearing. During the intense first few days the symptoms are constant, these symptoms might be made worse with head movements but they aren’t triggered by the head movements.

BPPV stands for Benign Paroxysmal Positional Vertigo which, as the name implies, is a feeling of spinning that comes on suddenly from certain head positions. It’s called benign because it’s not life threatening or progressive even though it is intense and debilitating. It is caused when particles in the inner ear, called otoconia, come loose and enter one of the inner ear canals. This is a fluid filled canal that helps our brain process head movement and when the particles move inside the canal they cause a false sensation of spinning. Vertigo attacks from BPPV are a sudden intense feeling of spinning that only lasts for 30 to 90 seconds. It can cause nausea and vomiting during the attack but afterwards it will settle down and you will be fine until another attack is triggered. BPPV attacks are ONLY triggered by specific head movements that cause the particles in the inner ear to move. These include getting into and out of bed, rolling over in bed and looking up or down.

Comparing the two conditions, we can find some key differences to help you know which condition you have. They follow very different patterns. Vestibular neuritis comes on suddenly and intensely, with the most intense vertigo lasting for a few days then fades over the following weeks and months, and the vertigo is not triggered by head movements. BPPV has a sudden onset of vertigo but is triggered by head movements but only lasts for a minute or two then will settle down. You will be fine between episodes but the triggering head movements can cause another episode. Each episode is consistent and feels the same. Based on this information you should be able to tell the difference between the two.

Now what can you do to get rid of the vertigo? For vestibular neuritis you are healing from a viral infection so getting plenty of high quality sleep is helpful. The symptoms generally fade on their own over weeks or months but a low inflammation diet can help as well as high doses of vitamin C and other anti-inflammatory and immune boosting supplements. Some doctors will prescribe anti-dizziness medications or steroids but these medications have questionable benefits and have side effects. Going to a physical therapist for vestibular rehab or finding vestibular rehab exercises online can help recalibrate your balance more quickly.

BPPV has a quick and easy solution. You can do a repositioning maneuver to clear the particles from the inner ear, which can immediately stop the spinning. You can go to an ENT or a physical therapist for this or you can just do it at home. Check out my BPPV Vertigo Cure video to learn the maneuver or click the link at the end of the video for a step by step guide on what to do and how to keep BPPV from coming back.

[Jgreen_]

Great video, I appreciate it. I think I’m suffering from the vestibular one. I had cold/flu like symptoms & a fever. Then the dizziness set in, I’m on day 3-4 maybe this can end soon.

[DONNAKINNE-ifdc]

I really wish there wasn't parts of the video to imitate dizziness for a group of viewers who are already dizzy.

[susanmainridge]

I have read everything I could find about BPPV and Vestibular Neuritis. But my Vestibular Neuritis never went away, and hasn't changed or improved. It does seem to get worse the day before a rain, hot humidity or very cold weather when the barometric pressure changes in the atmosphere or if Im flying on an airplane. On Feb-2-2016, I woke up with vertigo, all the symptoms that go along with it, never had tinnitus before this but it has remained quite loud too. I also had spinning sensation and double vision vertically and horizontally and a massive headache. At the time I did have a bad cold. I have had issues since childhood with sinuses draining into my ears. I did have tubes put in as a child. It has been 6.5 years later, and my vertigo never went away. I deal with it every day as soon as my head gets off the pillow, the spinning starts. So if my head is in motion-moving or if my body is in motion and my head is not moving traveling in a car, I get the same reactions and symptoms. The Neurotologist Inner Ear Specialist at Barnes Hospital in St Louis Missouri was my final diagnosis of Vestibular Neuritis. I had seen 2 ENTs, Audiologist and the Nuerologist Brain Specialist to rule out a stroke, brain bleed, tumor or multiple sclerosis. I was told by my inner ear doctor that in my case the damage to vestibular nerves from inner ears to brain was permanent and that I would first have to accept and then adapt to my new life with this disorder. Which I have done. Only thing that helped me with the anxiety, depression and stress that comes also with this was for me to retire early. I have been retired almost 2 months now and loving it. I have a question for you? I also have diabetes for a long time and it has done some damage to my optic nerve causing glaucoma so to keep my vision as good as it can be, I see a Retina Dr every 4 months. Is it possible that the diabetes could have played some role in the vestibular nerve damage? I wonder because I do have neuropathy pain kind of feels like ear aches all the time and the ear ringing never stops either. Just wondering since diabetes does damage to other nerves in the body. Thanks.

[elizabethsandobal]

THANK YOU SOO MUCH FOR THIS VIDEO.GREAT ADVICE 👍❤💯

[rickroller]

Thanks you so much for this video very informative
Appreciated ✌️

[joyzkagames]

Thank u so much for the information.. i do have the 2nd one which is BPPV.. i’m doing the Apley maneuver which is good for such case.. i’m not sure how many times do i need to do it to get back to my normal state.. I think it takes some time to heal

[antoniovasco]

It was very useful, Thank's Dr.

[brad]

I dont know which doctors to trust. I had a neuro episode in Jan 2021 diagnosed and debated as to whether or not my condition is, was or still may be as of 12/22 Vestibular. I've have swelling in my brain and balance and equilibrium daily for almost 2 years. How come noone can determine what's wrong ?

[PM-utxs]

But what would cause one to lose eye control? I can turn my head and my eyes will roll in the opposite direction. When I have a bad vertigo case I lose control of my eyes all together and they will roll in opposite directions. One up, one down, one left, one right. I can never see it because I can't focus my eyes enough to not see double.

[youzeri]

Hi doctor

I'm confused, I have symptoms of vestibular neuritis. It started with severe dizziness and vomiting for three days, then gradually subsided. However, I still feel dizzy whenever I turn my head to the left or when I roll over in bed to the left side. I was taking Tanganil and Betaserc, but their effect was very limited, and when I stopped taking them, I felt some improvement. I tried the Epley maneuver, but it didn’t help, and I tried the Barbecue Roll maneuver, which gave me some relief, but the dizziness hasn't completely disappeared. Now, it has been a month since the onset of the symptoms, and none of the doctors I visited could give me a clear answer. My blood tests are normal, and the MRI is also normal.

Can you help me, Doctor? Do I have vestibular neuritis, or is it benign paroxysmal positional vertigo (BPPV)?

Thank you.

[hananmrad]

Does vestibular neuritis cause heavy head?

[Kaylss]

Thank you for your thorough explanation. Could HSV-2 cause Vestibular Neuritis?🤔

[mindfulmediumsamantha]

i am so nauseated and dizzy for days after BPPV

[Jenifer_G]

Good vid but dont show the head moving like that its disturbing

[PeterJohns]

I am unaware of any evidence for the benefit of "low inflammation diet", Vit C, Turmeric, Vit D3 or Vit K2 or even"high quality sleep" in the treatment of vestibular neuritis. If you know of any evidence, please post it.