Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is a common condition of the inner ear. This condition causes short episodes of dizziness (vertigo) associated with certain head movements. These episodes are caused by particles (crystals) irritating the semicircular canals, the part of the inner ear which regulates balance and equilibrium. Besides dizziness, people with BPPV feel nauseous and may vomit during these attacks. BPPV tends to get better over weeks or months, but may reoccur.

Benign paroxysmal positional vertigo can occur at any age, however older people are more commonly affected than children and younger adults. The cause of BPPV is not well understood, however it is thought to be due to a problem in the inner ear caused by particles (crystals) irritating the semicircular canals, the part of the inner ear which regulates balance and equilibrium. In rare cases, head injury can lead to BPPV.

Recurrent, short attacks of dizziness are the main symptom of benign paroxysmal positional vertigo. The dizziness associated with vertigo often feels like the world is spinning, rather than a feeling of lightheadedness. The dizziness may be accompanied by nausea, vomiting and a loss of balance. The attacks often occur after changing position of the head, such as suddenly turning the head, or moving from lying to sitting.

Diagnosis is made by a doctor with the help of a physical examination. The diagnosis can be confirmed with specific tests.

This form of dizziness can be treated with certain repositioning maneuvers (Epley maneuvers or Brandt-Daroff exercises). During these series of controlled exercises, symptoms may get worse. After being instructed by the doctor in how to do them, people can do some of these exercises at home. Normally BPPV can be treated well in this manner. Medication is not used to treat BPPV, though might be helpful in managing nausea associated with the dizziness. In severe persistent cases surgery may be an option.

People with BPPV may need to avoid certain activities or movements which bring on an episode of dizziness, as the dizziness may make these activities unsafe.

• BPPV
• canalolithiasis
• cupulolithiasis
• Familial benign recurrent vertigo
• Familial vestibulopathy