BPPV From Binge Watching Netflix?

Jun 08, 2022

Have you ever heard of anyone getting BPPV from binge watching Netflix? We recently did.

Usually our blogs are more on the technical side. We, however, thought that we would change it up a bit with this post and use a case study format, especially given the interesting onset.

First of all we will figure out if binge watching Netflix can cause BPPV. Secondly, we will go over the actual case study.

So can BPPV be caused by watching too much Netflix?

The simple answer is, kind of.

With BPPV, really two things need to occur.

Why BPPV occurs?

BPPV occurs when these two factors coincide.

First factor

Some of the otoconia in the inner ear that help detect head position and motion need to break off. This is a normal process like your hair falling out. So, it is quite natural for the crystals to break off with time. Two other reasons for them to break off are:

They can be sheered off by sudden head motion or a hit to the head.
They also seem to break off more commonly when there is a pre-existing vestibular condition like migraines and Meniere’s Disease.

Now, when the otoconia break off, they trickle to the most dependent position of the inner ear where they are gradually absorbed over time.

Second factor

If before the loose otoconia are absorbed, a patient positions their head back and to the side, as we do when we lay on our side, this positions the opening to the semicircular canals in the most dependent position. The loose otoconia then may fall into the opening of one of the canals and cause BPPV.

For more information about BPPV click here.

So, it really takes two events to coincide to cause BPPV. The otoconia breaking free and the head being positioned so the loose otoconia fall into one of the canals.

Conclusions

So, based on the above, binge watching Netflix or any other streaming service cannot cause BPPV unless there already is some loose otoconia in one of the inner ears and your patient watches TV while lying on the same side as the ear with the loose otoconia.

Let’s Move Onto The Case Study

History:

42 year old reported having vertigo for seconds at a time with associated nausea, unsteadiness, and a pressure in the head with rolling over and with getting in/out of bed.
Started approx 10 days prior when she got off of the couch after watching Netflix for several hours.
Overall 0% better and no associated other 5Ds or aural symptoms.
History of dizziness and seeing black spots if stood up too fast.

Assessment findings:

Gait and communication WNLs.
No aides.
Neck AROM full and symptom free.
Extra-ocular mobility, smooth pursuit, head thrust, and saccadic eye motion (-).
(-) spont/gaze evoked nystagmus +/- room light.
Dix-Hallpike (+) to the right and (-) to the left.

Analysis of findings:

BPPV.

Treatment:

Education regarding the nature of her symptoms and of her favourable prognosis with treatment.
Consented to and was treated with a canalith repositioning technique. Post treatment Dix-Hallpike testing was unremarkable.

Follow-up:

Planned a follow-up visit for 4 days later. She called a couple of days after her initial session to cancel as she was feeling 100% better.

Video of case study (7min)

To see a video of the Dix-Hallpike test, the treatment provided, repeat Dix-Hallpike testing post treatment, and patient/practitioner dialogue for this case study, check out the video attached to this post. The first two minutes of the video review the history. The actual recording footage starts at the two minute mark.

Wrap-up

We hope that you enjoyed this case study. This case study is actually part of our “A Field Guide to BPPV” online course that will be released this summer.

If you want to look into this course or other educational opportunities that North 49 offers, feel free to check out our webpage.

Research shows that BPPV is often poorly understood, which leads to poor outcomes. Let’s change that.