BPPV

FYZICAL Therapy & Balance Centers BPPV Program

What is BPPV?

Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder that causes people to experience a sense of spinning dizziness. This condition occurs when small calcium crystals (called “otoconia”) get into one or more of the vestibular semicircular canals, and certain maneuvers must be performed to remove those crystals from the canals.

When this occurs, a Physical Therapist can observe a condition called “nystagmus” by looking at the patient’s eyes. Nystagmus looks like an uncontrolled, jerking movement of the eye and happens as a part of a reflex loop that connects the vestibular system to eye movements. 

Specialized equipment - Infrared Video Oculography Goggles (IVOG)

Sometimes nystagmus can be observed in normal room light, but this is not always the case. Some individuals have a natural ability to suppress nystagmus (or “fixate”) in normal room light. The use of infrared goggles helps a Physical Therapist block out room light and prevents a patient from suppressing nystagmus during positional

testing for vertigo, allowing for accurate diagnosis of their condition.  

FYZICAL Bridgeville uses specialized equipment called Infrared Video Oculography Goggles (IVOG) to assist your physical therapist in determining where your vertigo complaints might be originating from.

The goggles have invisible infrared lights that can illuminate the eyes of a patient suffering from vertigo and help to allow for a differential diagnosis between central/brain and peripheral/vestibular disorders. 

The IVOG goggles fit over the eyes similar to a pair of goggles you would wear snorkeling. They include a cover to block out room light, and a set of infrared cameras that provide video footage of the movement of the eyes to reveal nystagmus during head movements. The goggles connect to a computer to show us what is happening with your eye movements in real time. 

We can also record the video stream from the goggles and provide a copy to you to keep for your records, or to share with your physician. This can be helpful with more complex vestibular conditions where the diagnosis is not as straightforward as BPPV. 

When performing tests our therapist must look at what a patient’s eyes do during the specific testing. Some patients have learned compensation techniques to fixate their eyes on an object to help decrease their dizziness complaints. While this may help a patient feel better, it unfortunately, keeps the therapist from seeing an abnormal movement of the eyes during certain tests.

The goggles create a dark environment for the patient while projecting a video of the eyes to a computer screen. This prevents the patient from being able to fixate their eyes and allows the therapist to see any abnormal eye movements that could provide information as to the potential source of the patient’s problem.

Once we evaluate the eye movements we can determine the canal that has the problem, and then apply the correct and appropriate maneuvers to remove the crystals.

You can love your life again and not have to just "manage" with dizziness and vertigo! Our vestibular therapists at FYZICAL Bridgeville (located in South Fayette Twonship) are trained in the use of this specialized equipment and look forward to providing you with a complete evaluation for your vertigo and balance complaints.