If you’ve ever felt sudden dizziness or a spinning sensation, you’re not alone. Two of the most common causes of vertigo are Vestibular Neuritis and Benign Paroxysmal Positional Vertigo (BPPV). While they both affect balance and can be unsettling, they have different causes, symptoms, and treatments. Understanding the differences can help you seek the right care and manage your symptoms effectively.
What is Vestibular Neuritis?
Vestibular neuritis is an inner ear condition caused by inflammation of the vestibular nerve, which helps send balance signals to the brain. It is often triggered by a viral infection, like the flu or a cold.
Symptoms of Vestibular Neuritis:
Sudden and intense dizziness (vertigo) that lasts for hours or days
Balance problems and feeling unsteady
Nausea and vomiting due to dizziness
No hearing loss or ringing in the ears (unlike other ear conditions)
Vestibular neuritis can make simple tasks like walking or turning your head feel difficult. However, symptoms usually improve as your brain adjusts over time. Most people recover significantly within a few weeks, but some may experience lingering balance issues for months. Early intervention with physiotherapy can help speed up recovery and minimize long-term dizziness.
How Can Physiotherapy Help with Vestibular Neuritis?
Physiotherapists play a crucial role in diagnosing and treating vestibular neuritis. They assess your symptoms and create individualized treatment plans to improve balance, reduce dizziness, and restore normal movement. Physiotherapy interventions include:
Vestibular Rehabilitation Therapy (VRT): A structured exercise program designed to help retrain the brain and improve balance function.
Balance Training: Exercises that enhance coordination and stability to prevent falls.
Gaze Stabilization Exercises: Techniques to improve visual focus and reduce dizziness when moving your head.
Gradual Exposure Techniques: Designed to help reduce dizziness caused by motion and head movements over time.
What is BPPV?
BPPV happens when tiny calcium particles in the inner ear (called otoliths) move into the wrong area, causing brief but intense dizziness when you move your head.
Symptoms of BPPV:
Short episodes of dizziness (usually less than a minute)
Dizziness triggered by head movements (turning in bed, looking up, bending down)
Nausea (but usually not severe)
No hearing loss or ear pain
BPPV has an excellent prognosis, with most individuals experiencing full resolution of symptoms after one or two repositioning treatments. However, some may have recurrent episodes over time, requiring additional treatment.
How Can Physiotherapy Help with BPPV?
Canalith Repositioning Maneuvers: A physiotherapist can perform maneuvers like the Epley maneuver to reposition the displaced calcium crystals, providing immediate relief.
Vestibular Rehabilitation Therapy (VRT): A structured exercise program that helps the brain adapt to changes in balance and dizziness, improving long-term stability.
Education and Prevention: Learning how to avoid certain movements that trigger symptoms and how to safely recover when dizziness occurs.
Many people experience significant relief after just one or two physiotherapy sessions.
Vestibular Rehabilitation
Some individuals may continue to experience imbalance or motion sensitivity following any vestibular condition. Vestibular rehabilitation therapy (VRT) can help by:
Enhancing Balance and Stability: Improving coordination to reduce feelings of unsteadiness.
Reducing Motion Sensitivity: Exercises designed to help the brain adapt to movement more efficiently.
Improving Gaze Stabilization: Techniques to maintain clear vision while moving.
Restoring Confidence in Movement: Helping individuals return to normal activities without fear of triggering dizziness.
Key Differences Between Vestibular Neuritis and BPPV
Feature
Vestibular Neuritis
BPPV
Cause
Viral inflammation of the vestibular nerve
Dislodged calcium crystals in the inner ear
Type of Dizziness
Constant, lasts for hours/days
Brief, triggered by movement
Balance Issues
Yes, often severe
Usually mild between episodes
Nausea
Common and intense
Possible, but usually mild
Physiotherapy Treatment
Rehabilitation exercises to retrain balance
Repositioning maneuvers to correct crystal displacement
Prognosis
Gradual recovery over weeks to months, may have lingering balance issues
Usually resolves quickly with treatment, but may recur
When Should You See a Physiotherapist?
If you experience ongoing dizziness, vertigo, or balance problems, a vestibular-trained physiotherapist can assess your condition and provide effective treatment. Seeking help early can speed up recovery and prevent long-term issues.
Takeaway
Physiotherapy plays a crucial role in treating both vestibular neuritis and BPPV. If your dizziness is constant and severe, vestibular rehabilitation therapy can help. If your vertigo happens in short bursts with movement, repositioning maneuvers can offer quick relief. Seeing a physiotherapist for assessment and treatment can help restore your balance and improve your quality of life.
Written by Matthew Long, Physiotherapist