Is there a relationship between BPPV and Meniere's disease?
Editor’s note: The answer to this frequently asked question was published on Healthy Hearing in January 2003. Due to its popularity, we’ve revised and updated the information to publish again today.
No. Although both disorders are associated with vertigo, they are not usually related. However, it is possible to have both disorders at the same time. Vertigo is intense dizziness and the feeling that you are spinning or your head is spinning. People who live with vertigo know it can be debilitating when it strikes.
Dizziness caused by BPPV
Benign Paroxysmal Positional Vertigo (BPPV) is a common type of vertigo associated with the ears. Most cases of BPPV have an unknown cause. Vertigo from BPPV occurs with specific movements of the head such as lying down, turning the head a certain direction or hanging the head upside down. Within the inner ear is a structure called the labyrinth which contains three looping structures called semicircular canals. The semicircular canals contain fluids that help monitor the position and rotation of your head. Also associated with balance in the inner ear are the otolith organs which contain tiny crystals. While we don’t know exactly why, these crystals can become dislodged and, with certain head movements, find their way into the semicircular canals. This causes intense dizziness that’s usually characterized by a spinning sensation. This sensation lasts less than five minutes.
Dizziness caused by Meniere’s disease
Meniere’s disease is a condition where the membranes and structures within the inner ear contain too much fluid and become distended. Its cause is not well understood, but Meniere’s disease has a classic trio of symptoms: fluctuating hearing loss in one ear, vertigo and tinnitus (ringing in the ears). Some patients also experience a feeling of fullness in the affected ear. Most episodes of vertigo with Meniere’s disease are not related to head position as with BPPV. The attacks can occur without warning any time and can last more than 20 minutes each time. These episodes can bring about severe nausea and vomiting until they subside.
Treatments for each disorder
Many patients with BPPV get relief from a treatment called the Epley maneuver which involves moving the head in a specific series of positions in an attempt to force the dislodged crystals out of the semicircular canals.
If Meniere’s disease is diagnosed, patients can get relief from a pressure pulse generator called a Menniett Device and sometimes prescription anti-dizziness drugs such as Antivert. Patients are also advised to reduce their salt intake and take diuretics to reduce fluid retention in the inner ear. Hearing loss associated with Meniere’s disease can be corrected with a hearing aid in the affected ear if appropriate.
How to take action
If you suffer from vertigo or dizziness, your best course of action is to visit your primary care physician and ask for a referral to an Ear, Nose and Throat specialist (ENT). They are well-equipped to evaluate your symptoms and help bring relief whether you have BPPV, Meniere’s disease or some other disorder. If you are experiencing hearing loss as well, be sure to request a hearing evaluation during your exam.