From the Research
Bilateral BPPV occurs in approximately 12.5% of all BPPV cases, as reported in the most recent study 1. This condition is relatively uncommon, and most patients with BPPV experience symptoms in only one ear (unilateral), making bilateral involvement a less frequent presentation. When bilateral BPPV does occur, it can be more challenging to diagnose and treat as symptoms may be more severe or confusing for patients, with vertigo potentially triggered by head movements in multiple directions. The condition results from calcium carbonate crystals (otoconia) becoming dislodged from the utricle and entering both right and left semicircular canals simultaneously or sequentially. Some key points to consider in the diagnosis and treatment of bilateral BPPV include:
- Risk factors that may increase the likelihood of bilateral involvement include head trauma, advanced age, osteoporosis, or prolonged bed rest.
- Treatment typically involves performing the appropriate repositioning maneuvers (such as the Epley or Semont maneuvers) on each affected ear separately, often starting with the more symptomatic side.
- Complete resolution may require multiple treatment sessions, and patients with bilateral BPPV may experience longer recovery times compared to those with unilateral involvement, as noted in the study 1. It's essential to approach each case individually, considering the patient's specific symptoms, medical history, and response to treatment, as highlighted in the studies 2, 3, 4, 5.