BPPV

BPPV stands for Benign Paroxysmal Positional Vertigo.  It just means you’re dizzy.  If you have BPPV, here’s why you are dizzy.

When I was 2 months out of a massive stroke and had a shaved head, I went to the ER with a severe headache and dizziness.  2 months out of a stroke remember.  So the ER doctor had no idea why I was so dizzy and diagnosed me with BPPV and explained that an inner ear condition is most likely causing my dizziness.  2 months out of a cerebellar stroke, a stroke that’s MAIN symptom is dizziness.

Ok, anyway….if you actually have BPPV here’s what is going on….In your inner ear in the vestibular system there are these crystal things.  These crystal things and where they are located make you sense your position, if you’re upright, stuff like that.  Sometimes, these crystals get dislodged and are in places they shouldn’t be and make you feel dizzy and nauseous.  And sometimes they will cause you to have nystagmus.  If you had a stroke I’m sure you know what nystagmus means.  It’s when your eyeballs track back and forth rapidly.  There is a maneuver that vestibular PTs perform that puts those crystals back where they belong and hopefully resolves the dizziness.  This maneuver will not work when one has had a huge stroke.  I wish that ER doctor was right and that BPPV actually was the cause of my dizziness.

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Categories: Health, Rehab, Stroke stuff

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33 replies

  1. I am a little over six months out from my stroke now and I have dizziness almost 24/7, sometimes more tolerable than others. It always feels like I have had at least a few drinks as far as how my sense of balance feels when I am walking. I have asked if this is what I can expect but have received different answers and this has been one of the most frustrating issues post stroke for me. One doctor says it is brain damage, another says it is because of the anticonvulsant RX ,Keppra, which they prescribed for me following my bleed. I have to take it for another 6 months (based off of my latest MRI) so I guess I will just have to deal with it. I wish I could at least determine what is drugs and what is my new reality.
    Just venting!! I can’t get any answers from my doctors!! Does anyone know about Keppra?

    • Have not heard of this. Did you have a cerebellar stroke?

      • They said I had an ICH that had extended into the ventricular system, so ICH and IVH shows up on my diagnosis. Along with “hypoplasia of a segment of the anterior cerebral artery in the Circle of Willis”. No one ever used the term cerebellar stroke so I am not sure. Just trying to learn since no one really explained it to me.

    • Did you have seizures? Why are you on Keppra?

      • They say prophylaxis. There is a lot I cannot remember from the hospital, I wish I knew. Your post about dizziness just struck a nerve because I was just discussing this issue yesterday at the doctor’s office without really getting anywhere. I did not have this kind of dizziness before the stroke, I know that much.

    • I took keppra for 2 years and hated every minute of it, although it helped with the seizures so it was a love/hate. Im guessing the dizziness u have is not from the keppra. It usually causes tiredness, “brain fog”, slowness. I guess it could cause dizziness but then you would notice as it wears off, you would feel better. Keppra is short acting only lasts like 12 hours unless u r taking extended release or slow release. Dizziness is very common after many types of brain injuries. Mine was the very first symptom and it returns when I’m really exhausted or if I move too quickly, move my eyes too much, or am surrounded by too much noise. I did vision and vestibular rehab which helped a lot although they involved tons of nauseating repetitions. Good luck!

  2. When I was admitted they pulled the same thing on me. “Probably just BPPV; you’ll be out of here tomorrow”. 2 days later I finally convinced the to send me a neurologist, who quickly ordered a CT scan and MRI, confirming my PICA cerebellar stroke.

    The problem with cerebellar strokes is the symptoms are different from cerebral strokes & the latter constitiute 97% of strokes with the cerebellar only 3%. So it’s no wonder a typical(lamebrained) ‘hospitalist’ dr. doesn’t recognize the symptoms.

    Nearly 2 years out my dizziness is still by far my biggest problem, leaving me confined to a wheelchair in the house although I can and do walk (more like hobble) 2-3 miles every day in my back yard.

    • Your neurologist quickly ordered an MRI? You’d think quickly ordering an MRI would be a standard/common thing for a neurologist to do.

    • The problem was not with the neurologist. She ordered the MRI and CAT scan as soon as she saw me. The problem was with the incompetent ‘hospitalist’ who, despite my urgings, didn’t summon her until 2 days after I was admitted.

    • HOW HAVE YOU PROGRESSED IO WALK (HOBBLE)? JULY 4 WILL BE 2 YEARS SINCE I HAD ISCHEMIC STROKE AND STILL CAN’T EVEN HOBBLE= WALK. STILL EXERCISING EVERY DAY AND GOING FOR THERAPY ONCE WEEKLY. THANKS FOR ANY SUGGESTIONS FROM ANYONE. HAS ANYONE REGAINED BALANCE? THAT’S MY PROBLEM

      • Sally, did you suffer a cerebellar stroke? There’s a lot of difference between that and cerebral. I am making slo-o-o-ow progress walking but don’t feel secure walking around the house so use my wheelchair most of the time. I have pain in knees and legs generally when getting up from sedentary position or walking around house. For some reason walking straight down & back my yard is much less of a problem. After 1 mile I have to quit, am pooped and dizzier than normal. Then I wait ~ 2 hrs. for the next mile. On a good day I cover 3 miles that way. That in fact is the only rehab I still do. I found professional rehab more or less a waste of time. They can’t do anything about dizziness. I think you have to just wait it out.

        Total loss of temperature sensation all down right side of my body (very cold & hot temps. generate horrible pain not at all like a “temperature” pain.) Also have double vision (diplopia) which seems to have improved the past year or so – I can get rid of it if I look at an object straight-on but not otherwise.

        • STROLE IS REFERRED TO AS CEREBELLAR RE ME. I DID NOT HAVE BRAIN BLEEDING. IS THAT WHAT YOU MEAN? MY LEFT SIDE BADLY AFFECTED BUT CAN STAND AS LONG AS I CAN TOUCH SOMETHING. USE WHEELCHAIR. IF I TRY TO WALK, I FALL, BUT CAN WALK SOME WITH WALKER. FEEL INSECURE WALKING W/IT. MIGHT GET “U-STEP” LIKE I CAN USE AT THERAPY. like you, knees & legs hurt – IN AM WHEN I GET UP. DO YOU THINK I WILL IMPROVE IN TIME? WHEN DID YOU HAVE STROKE? GOD BLESS, SALLY

          • No, neither of us had a hemorrhagic (bleeding) stroke. Ours are ischemic which means blood supply was interrupted to our cerebella, killing some of the cells. In that very limited sense we were lucky; recovery from hemorrhages are poorer. Problem is there is limited data available for recovery following a cerebellar stroke. That’s because 97% of strokes are cerebral and only 3% are cerebellar. I am attaching a couple of links you may want to look at.

            http://stroke.ahajournals.org/content/32/2/530.full
            http://www.stroke-survivors.co.uk/

            I will be 2 yrs. out in October.
            You have to give this time and exercise. Substantial recovery depends probably on your age. For me (age 72) it’s very unlikely but I have been improving. My diplopia (double vision) has improved somewhat and so has my dizziness, and I walk more easily although ‘teeter’ is still a better description. I hope you do more than 1 day/week rehab. They should give you exercises you can perform safely at home. For me it’s walking 7 days a week, schedule permitting.

            Good luck,
            rudy

            • Rudy, Thanks for responding. I, too, have double vision. Therapists give me exercises which i do at home every day and I am going to an opthamologist/surgeon in August, hopefully having surgery to correct double vision. Am your age. Want to walk and drive car, be independant again. I thank God for my mind and other blessings, but wish He’d heal brain.

              • That pretty well sums up my situation. I didn’t know surgery was an option for the diplopia. Anyway, I don’t intend to pursue that idea. As I said, one of the few concrete signs that I’m getting better is that the diplopia seems to be somewhat self-correcting. The prismatic glasses they prescribed for me are now useless.

                Best to yiou.

                • Per 2 opthalmologists, my diplopia isn’t going to heal – need surgery. glad to hear yours is self-correcting. i did eye exercises.& saw some improvement, but still double vision, so looking forward to surgery.
                  Let’s not let age interfere with progress! we’re still here.
                  Good luck to you.
                  Sally

                  • Good luck with your surgery, Sally. Would appreciate hearing how it went.

                    Mine improved but did not correct & I don’t think it ever will. If I don’t look at an object head-on the images still split. Initially they were split under any head orientation.

  3. Zack was first diagnosed with allergies and then vertigo. We went for three weeks believing it was vertigo…. As he continued to decline. Finally we went to the Stanford ER where he saw a neurologist within 30 minutes who told us within 15 that he likely had an issue wih his cerebellum.
    Stuuuuuuupid.
    His dizziness subsided months ago, shortly into recovery. But everything else is still super messed up- balance, vision, speech, ataxia, even executive functioning and some emotional stuff.

    Brain injury is a super bitch.

  4. Absolutely my biggest problem .. dizziness, nausea and vertigo to the point of vomiting, clinging to furniture., falls… lots of bad falls.
    One early suggestion was BPPV as well as the brain injury maybe as a result of one of the falls . Never bought that one.

    I had some vestibular therapy mixed in with the rest of the rehab but frankly it was poor. I wound up volunteering as a guinea pig for a university Neuro physiotherapy practicum class. Their teacher… hot shot Phd,. did a serious of tests on me in front of the students and tada. definitively brain damage related to left side vestibular and hearing systems. (and some left hearing and vision processing delays too.) She was clear about exactly what to do to improve.
    I have spent years now intentionally doing things that make me feel absolutely rotten, under safe conditions, to try and retrain my brain. I would say at almost 5 years post I stopped feeling awful. Now it is a lot more episodic like when someone throws a ball at me. loud sharp noises, I turn my head fast to look over my shoulder.

  5. Oh the old BPPV dx… The lame catch all…oh ur dizzy…we don’t know why so its BPPV…my first dx when I went in complaining about dizziness even though my MRI showed a large bleeding cavernous angioma….idiots!! It took me almost a year to figure it all out and find a doctor that actually knew something about angiomas.

  6. More proof that our doctors are incompetent. Its one of the reasons I never plan on seeing a neurologist ever again unless they are paying me the big bucks.

  7. my balance is totally gone. Have hard time using a walker. am okay sitting in wheelchair and mind is fine. NO BALANCE IS HORRIBLE.

  8. OK..so why didn’t I know about BPVV? After all of the doctors I have been to see and all of the info I have read, this is the first time I have seen this…duh!!
    After two years, I still can’t walk without assistance and am nauseous unless I am sitting very still. I am tired of people saying that I have been through a lot and need to give it time. I have given this stroke two years of my time already ! I could deal with the physical limitations if I wasn’t so sick all the time.

    • Clairese it’s actually probably a good thing that you haven’t heard of BPPV. If you had a stroke, particularly a stroke in the cerebellum, BPPV is not causing your dizziness. I take that back, anything’s possible but there’s a very very small chance that BPPV has anything to do with your dizziness.

  9. Yes, I did have a cerebellar stroke then brain surgery to remove the half that had died. THEN after a month in the hospital I had several complications to include meningitis. My double vision did go away but still wobbly and nauseous if I try to move my head too much. My mind does seem to be less “foggy” this summer. I would LOVE to use my kayak again !

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