Meniere's Disease vs BPPV (how to tell the difference)
ฝัง
- เผยแพร่เมื่อ 29 มิ.ย. 2024
- If you're suffering from vertigo, dizziness and lightheadedness, your first step in eliminating these annoying symptoms is to figure out the cause/diagnosis.
Two of the most common causes of vertigo and dizziness are Meniere's Disease and BPPV (benign paroxysmal positional vertigo). In this video, I'll break down how to tell the difference between these two causes.
Here's a quick rundown of the main points:
- BPPV is often sudden and intense, following specific positional changes
- Meniere's is not as sudden and doesn't often involve positional changes
- The duration of vertigo is typically shorter with BPPV (10-20 seconds)
- The duration of vertigo with Meniere's is often 20 minutes to several hours
- Meniere's often involves tinnitus (ringing in the ears) as well as hearing loss (BPPV doesn't)
- BPPV will typically reveal rapid eye movements (nystagmus) with positional testing, while Meniere's does not
If you have more questions on diagnosing the cause of your vertigo or dizziness, please leave a comment below!
- Luke Gordon, DPT
Doctor of Physical Therapy/Owner of Gordon Physical Therapy
www.gordonphysicaltherapy.com...
I have been dealing with both of these symptoms for YEARS off and on and now I have permanent hearing damage and wear hearing aids. I have a new doctor that will hopefully give me a referral to an ENT doctor who knows what they are doing because I think I may have both. My symptoms go back 10 years maybe longer. It's been a challenging journey that's for sure.
Seeing and ENT is an excellent choice! I hope it goes well and you get the help you need :-)
Love the vestibular videos!
Thank you!
Thank you!
I had BPPV, for about 20 years then it went away; a history of migraine for 9 years which also went away... and 6 decades of classic vestibular migraine symptoms only recently diagnosed as vestibular migraine (in 2022) but I meet the criteria for not only VM, but Meniere's as well as MdDS. I have multiple classic symptoms but the worst are the tinnitus which is a head roar, not high pitched ringing (I do have that in my right ear, but the head roar which is dx a tinnitus isn't in either ear...it's in my head), the sensation of the floor vibrating, and balance issues...the tinnitus, vibrations and balance issues are miserable much of the time. Meds worked for awhile, then they stopped working. It'd help to know if I have all 3, 2 or 1 and if only 1, which one.
Hey Gordon, just wanted to say thanks for your super helpful video on vertigo. It really helped me understand what I went through when I had my first episode recently. I was so scared, thought I was dying! Ended up going to the ER and got prescribed Betaserc. Quick question for you: I'm planning to get the seasonal influenza shot next week. Do you think it's safe to take Betaserc and get the vaccine? Thanks again for all your awesome content!
You're welcome! I'm really not sure about the flu shot and Betaserc together... I'd ask your doc or the pharmacist.
I'd like to thank you because your videos helped me figure what ear and canal my BPPV was in and what positions to resolve it, I did not have nystagmus which was strange though.
Thank you for your kind words! I'm glad these videos have helped you! You bring up a good point with positional testing that a lot of people don't know: if you have the sensation of vertigo but no eye movements (nystagmus), the test is still positive (meaning you need to treat that side). I should probably make a video about that... thanks!
@@GordonPhysicalTherapy that is very good to know, i have been panicking because with my PT we did the dix-halpike test and treated with epley for my left side 3 times.. each time i felt intense vertigo on the left side and then when sitting up, but i didn't have any nystagmus. i was so anxious that it wasn't bppv because there was no nystagmus. im relieved to know it still counts as a positive test
Hey Dr Gordon , really nice video! I was wondering if I could help you edit your videos and also make a highly engaging Thumbnail which will help your video to reach to a wider audience .
You're welcome to email me with your ideas: luke@gordonphysicaltherapy.com
"Hey Dr Gordon , really nice video!" Agreed!
As for editing; if it ain't broke, don't fix it!
@@GordonPhysicalTherapy Done Dr Gordon 👍 Please go through it and respond it !!
Hi Gordon thank you for all of your content.
Can you please give me some advice?
One month ago I - 27M woke up after my BJJ training with extreme dizziness on standing and turning in bed with ass. severe nausea. This is my first ever episode!! I had horizontal nystagmus on the dixhallpike test (head rotated to right). At this stage I was unaware of the complexities of treating BPPV so did the elpey manurer in which my eyes beat rapidly when turned to the right and at a much slower pace when turned left. 10 minutes after the elpey I felt relief and there was no nystagmus upon repeating the dixhallpike. I had some disequilibrium remaining.
One week ago I experienced another dizziness episode after a BJJ training and performed the epley and experienced symptom relief. Since then I have been feeling dizzy on sudden head movements particularly in the mornings. I have no nystagmus on the dixhallpike and have done the epley several times with little symptom improvement.
Based on your videos I believe I initially had horizontal BPPV which was most likely the variant in which the crystal is stuck to the cubical where the correct manoeuvre should have been to do a BBQ role or Gufoni. However now I do not have any nystagmus and am unsure what to do.
Do you have any symptoms or nystagmus with the Supine Roll Test?
So I had a sudden massive vertigo episode (1st one ever) just over a month ago. My eyes went like pinballs & I couldn't walk without holding the walls & ended up in A&E as I had no idea what was happening at the time. The DR did the Epley maneuver but it didn't work & even now my balance is still off when I move my head. My eyes aren't shaking now but don't really feel like they're 100% again. Sounds like I have symptoms that cover both situations. I'll be going to an ENT Dr to see if there is anything else going on.
I hope the ENT can help! And don't hesitate to reach out to a vestibular PT if you can find one in your area.
hi doc ,i had a vertigo attack when i was rising from my bed ,then i laid down and after an hour i tried to get up again and it stroke me again ,then i moved quicly to the other side of bed(somehow semont manuevre) and finally it stopped. i did MRI and my ENT did not find anything even i have tinnitus ,he said mostly bvvp But the main problem i have is that i feel dizziness 2 days or a day before a weahter change and it is gonna rain.When it rains the dizziness 90% goes away.My neyrologists said that it because of muscles convulsions of neck (i have stenosis also) that press the blood arteries and the blood does not reach well on the brain and cause dizzeness ,So what is your opinion?
I do the , half summersault vertigo exercise to help control it.
Glad that works for you!
Hello, my initial symptoms 3 years ago was that i felt dizzy if I kept looking down in the kitchen for long time cutting vegetables or while looking down while having a meal. Last year I had kept my head back for few hours during a prolonged meeting and my head started spinning, the surroundings did not spin but I felt that I was moving and my symptoms have not fully gone yet..Still have residual light headedness and I also have a feeling always that my ears are filled with liquid. Rarely tinnitus symptoms but I get it few times in one ear and I get pain behind that ear if I work with my laptop for more time. Should I go to my ENT or Vestibular PT for this?
I would start with the ENT first.
I have been diagnosed with BPPV but I don’t have all those eyes movements… I’m dizzy simply when I walk and turn my head right or left or when I move faster… my balance is definitely not great those days. Can you tell me if this sounds like something else? I have a hard time getting an appointment at this point.
Epliley test works get it done,
ok, thank you Julie. @@juliehurst3846
It doesn't sound like you have BPPV to me, more along the lines of dizziness and lightheadedness. I'd work with your doctor or an ENT to find a solid diagnosis, or possibly a skilled vestibular PT in your area if you can find one. I hope that helps!
I have menieries 13 years ago - little tinnitus , vomiting , hours of vertigo - that stopped in 2019 . Now I get episodic vertigo ( can be seconds ) often preparing food etc . I’ve also had 2 drop attacks in last 3 months . Can I have menieries and bpv ? Ent wants to inject gentimicim in affected ear - but I’m anxious about destroying my sensory organs! Do I go to a chiro or osteo for bpv manurveres ? Thanks
Check ur vitamin b12 and d levels…dizziness can also be caused by these
Think I have both lucky I'm seeing a vestibular physio is a few days
Seeing a vestibular PT is a great choice, especially if you have a complex case!
Hi! I have been diagnosed with BPPV by my doctor and my ORL (French name for the specialist of the ear). Both saw a nystagmus. The second did a Semont Maneuver. Then, one week later, I saw a physical therapist that did an other maneuver but he didn't saw the nystagmus anymore. For him, it was actually a good sign, and it was the end. The problem it's nothing change since the beginning. I never had one vertigo, only a weird dizzyness (it's moving inside me only) when I'm moving all the time. I feel like I'm on a cloud (drunk) and, something is pulling me in a way or in other. I had more tinnitus than before, at least one at two a day, very short. And after seeing the physical therapist, I had the weird felling that my ear was clogged, then fine, then cloggeg, then fine... for a full day. I'm going to see a specialist center on vertigo in the month with a lot of equipment but I'm curious to know how quickly those maneuvers are supposed to work with a BPPV and how powerfull and long is supposed to be a vertigo for a Meniere's Disease. I'm also curious about PPPD. Thanks
I'm glad to hear that you're seeing a specialist for your vertigo. BPPV maneuvers typically work right away, although you can have residual symptoms afterwards that benefit from vestibular exercises. With fullness and ringing in the ears, you definitely want to look into Meniere's Disease, more so than PPPD. I hope that helps! Let everyone know how your vestibular consult goes :-)
My grandmother and aunt both have menieres and I have ear fullness but my ent says I have bppv. I’m wondering if I should get another opinion.
Get another opinion. Meniere's Disease symptoms are Ear fulness, Vertigo, Tinnitus and Vomiting or Nausea. Plus, you can have other symptoms like balance problems, brain fog, sweating for no reason, tingling, nerve pain on the affect side or ear, etc.. And some people have migraines too.
Once bppv has been treated with eplay and vertigo been gone, can i return to normal routine like doing basic yoga???
Downward dog a no no
Yes, you should be able to after about 2 days. And if the vertigo comes back with any of the poses, but treat again right away.
Thanku sir
This is weird. A physio did the Epsley Manoeuvre on me and my eyeballs went nuts and he says it's BPPV. But I've been off balance for months like I'm rocking on a boat day and night. Nothing in particular makes it really worse except for bending forward and looking up. It lasts all day long. I have bad tinnitus in my ear and an audiologist just found moderate hearing loss as well. I feel lop sided all the time and it's like there's a disconnect between my body and brain. Nothing makes it better although I don't seem to notice it so much when I'm in a car. Didn't have a fall or hit my head and don't have a history of vestibular neuritis or vestibular migraine. .... But that Epsley Manoeuvre sent my body into sickening spiraling torture for 30-40 seconds. Then when he finally sat me up I was a lot better than when I went in. The next day my balance wasn't as good as the night before but wasn't as bad as before I saw the guy. Then today he did it a second time and it wasn't as horrific when he dropped my head down as the first time but then when I sat up today I wasn't any better. I felt better after the first time than the second time today. He's doing it again next week..... It doesn't explain my tinnitus and hearing loss and my continual feeling of being off balance.... Some days it's worse than others and when it's bad I can hardly even think and I vomit. Then I can't eat. Then keeping down water gets hard. I start to get dehydrated and then I get diarrhoea. With all that going on I can't sleep at all in the night so I get a headache as well. My eyes start to water and sting and I become super sensitive to light and in the end I don't leave my BSC until it improves and in the meantime I spiral into depression and maybe then a few days later when it finally improves a bit I find I've also lost 5-6kg....
I'm sorry to hear about your situation and how severe your symptoms have been! It sounds to me that it's very likely you have BPPV but that you also have other inner ear issues, as BPPV in not related to hearing loss and tinnitus. Having headaches on top of that is horrible! Are you working with an ENT as well as the PT?
I'm also dealing with same problem as u dealing
what is the difference between meniere and sshl?
I'm no expert when it comes to SSHL or hearing loss, but I can tell you most people with Meniere's have a gradual hearing loss, as well as dizziness, fullness in the ear, and ringing (tinnitus). SSHL sounds more sudden and often complete loss of hearing. An audiologist can probably tell you more....
@@GordonPhysicalTherapy tyyy
Hey Luke, Great contents! I sent you an email. I look forward to your reply. Thank you.
Thank you! I'll follow up with you soon :-)