Benign Paroxysmal Positional Vertigo (BPPV)

May 8, 2017 |

Inner ear diagram

What is BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. This is the MOST common cause of spinning dizziness. It has been estimated 20% of patients seeing a physician for dizziness have been diagnosed with BPPV.

There are a few key characteristics for diagnosing BPPV:

  • Triggered by position change; typically turning over in bed or your head movements.
  • Usually does not last more an a few minutes.
  • May cause nausea and vomiting if the dizziness is severe.
  • Periods of normalcy in between dizzy attacks.
  • No other associated symptoms such as aural fullness, hearing changes, or tinnitus (ear ringing).

BPPV occurs when the otoconia also known as crystals in the inner ear break free. These crystals are found within the semicircular canals in the inner ear. When the crystals break free they can cause dizziness because they are free floating around in one of the canals they are not supposed to be in. The semicircular canals are in charge of helping the brain determine where the head is located in space relative to gravity.

Normally the crystals are anchored in the semicircular canals and their motion is limited. When a person turns their head, the anchored crystals sway and stop quickly with the motion. This movement is how the inner ear tells the brain a head turn just occured. When these crystals break free they keep moving even when the head has stopped. This causes the inner ear to tell the brain the head is still moving even though it is not. This will cause the person to experience a spinning sensation; the spinning sensation will end when the freed crystals have stopped moving. When BPPV is suspected based on case history; a maneuver is used called Dix-Hallpike to confirm the diagnosis.

In my next blog I will continue with some BPPV treatment options. In the meantime if you suspect you have BPPV please call our office to make an appointment.


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