Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is a condition related to the inner ear that causes brief, intense episodes of vertigo. Vertigo is a type of dizziness characterized by the sensation that you or your surroundings are spinning or moving around.

Causes and Risk Factors

BPPV occurs when small crystals in the inner ear become dislodged and move into one of the semicircular canals, which are filled with fluid. This movement of crystals causes the inner ear to send false signals to the brain, leading to the sensation of spinning or vertigo. The exact cause of BPPV is not always known, but it can be triggered by:

• Aging
• Head injury
• Inner ear infections
• Ear surgery
• Viral infections
• Genetic predisposition

Symptoms

The primary symptom of BPPV is vertigo, which is often triggered by specific head movements such as:

• Rolling over in bed
• Getting up or lying down
• Looking up or down
• Turning the head from side to side

Episodes of vertigo can last from a few seconds to several minutes and may be accompanied by:

• Nausea and vomiting
• Lightheadedness
• Loss of balance
• Hearing loss (in some cases)

Diagnosis

BPPV is typically diagnosed based on a physical examination and medical history. The Dix-Hallpike test and the roll test are commonly used to diagnose BPPV. These tests involve specific head movements that can trigger vertigo and help identify the affected ear.

Treatment

The primary treatment for BPPV is a series of maneuvers called the Epley maneuver or canalith repositioning procedure. This involves a series of specific head and body movements that help to move the dislodged crystals back into their normal position in the inner ear.

In some cases, vestibular rehabilitation therapy (VRT) may be recommended to help improve balance and reduce symptoms of vertigo. Medications such as antihistamines or anti-nausea medications may also be prescribed to help manage symptoms.

Prevention

While it is not always possible to prevent BPPV, there are some steps that can be taken to reduce the risk of developing the condition:

• Avoid heavy lifting or bending
• Avoid sudden head movements
• Get regular exercise to improve balance and flexibility
• Manage stress and anxiety

Prognosis

The prognosis for BPPV is generally good, with most people experiencing significant improvement in symptoms after treatment. However, some people may experience recurring episodes of vertigo, and in rare cases, BPPV can lead to more serious complications such as hearing loss or balance problems.