Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo, best described as a false sensation of spinning. BPPV is sudden in onset, and usually only lasts in brief spells. It is typically triggered by movements of the head or certain head positions.
BPPV is a mechanical problem in the middle ear. It occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the inner ear become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be. When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.
BPPV symptoms are most commonly felt after a change in head position, causing the feeling of the room to spin, often combined with nausea. Patients can even vomit from symptoms.
Treatment of BPPV commonly uses mechanical repositioning of the crystals. The most common manuevre for this is the Epley. Many studies show the effectiveness of repositioning manuevres for BPPV to be above 90% after 1-3 treatments.
It is important to know that BPPV will NOT give you constant dizziness that is unaffected by movement or a change in position. It will NOT affect your hearing or produce fainting, headache or neurological symptoms such as numbness, “pins and needles,” trouble speaking or trouble coordinating your movements. If you have any of these additional symptoms, tell your healthcare provider immediately.
BPPV is a common problem, and will be encountered more and more as our population ages. The impact can range from a mild annoyance to a highly debilitating condition, and can affect function, safety and fall risk. Fortunately, symptoms tend to decline over time as the brain slowly adjusts to the abnormal signals it is receiving, or because the condition spontaneously resolves. However, with a health care professional who is appropriately trained in the assessment and treatment of BPPV, most patients are pleased that their problem can be easily corrected so their world can stop spinning.