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Benign Paroxysmal Positional Vertigo (BPPV)

Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.

Though not an indication of a serious health problem, benign paroxysmal positional vertigo, or BPPV, is when an individual feels as though they are spinning, tilting or the room around them is spinning (even when the person is still). BPPV comes and goes in short spells, lasting 1-2 minutes. Yet, this balance & dizziness condition itself can hang around for weeks at a time.

To better understand, BPPV is a condition of the inner ear. Designed to help individuals maintain balance, tiny calcium particles are inside the inner ear. In response to standing up, moving the head, bending forward or rolling over in bed, these calcium particles move. Yet, if there is inflammation or infection present in the inner ear, the calcium stones do not move accordingly. As a result, a false signal is sent to the individual’s brain, which triggers BPPV.

For some, symptoms of BPPV are mild and do not interfere much with everyday life. Yet, for others, symptoms are severe and may make it difficult to stand or walk without becoming off-balance or falling. In other cases, individuals experience nausea and vomiting.

Determining if an individual has BPPV is usually accomplished through specific questions and a physical assessment. One particular test, the Dix-Hallpike, involves monitoring a person’s eye movements as they turn their head and lay back.

Treatment and Rehabilitation for Vertigo

While the history of vertigo suggests that it goes away within a few weeks following its onset, physiatrists understand that for many patients, vertigo is severe enough to put a damper on their everyday life.

Physiatrists are in a unique position to organize and oversee treatment and rehabilitation that empowers patients as they combat the effects of vertigo. Because physiatrists assume a multidisciplinary approach, they draw connections from multiple fields including psychology, neurology and rheumatology. With an understanding of how multiple systems work and how they contribute to a patient’s symptoms, they are able to customize a treatment protocol that is both helpful and effective.

Specifically, the Epley maneuver and the Semont maneuver are procedures used to treat or eliminate vertigo. These 10-15 minute repositioning techniques aim to move the calcium crystal (canalith) particles into an area of the inner ear where they will no longer cause symptoms. While initial treatment should be done in an office, physical therapists or interventionists can teach patients a modified version of the Epley and Semont maneuvers to apply at home. These maneuvers can assist in the effort to attack ongoing episodes of vertigo in the future.

At the Howard Liss, M.D. Rehabilitation Institute, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.

To schedule your appointment, contact the Howard Liss, M.D. Rehabilitation Institute today.


Rehabilitation Institute

111 Dean Drive Suite 1
Tenafly, NJ, 07670
Fax: (201) 871-2214

Call Us: (201) 390-9200