Benign Paroxysmal Positional Vertigo (BPPV)
Benign paroxysmal positional vertigo (BPPV) is the most common cause of episodic vertigo. It occurs when some small, but heavy particles called otoconia come loose and settle in one of the semi-circular canals.
When you change position (tilting your head back, rolling over in bed or lying down), the debris moves through the canal causing a temporary fluid imbalance (much like the wake from a speeding boat).
BPPV Symptoms and Causes
Patients with BPPV typically experience vertigo in short, intense episodes that last less than one minute. BPPV is a mechanical dysfunction of the inner ear and does not usually indicate an ongoing disease process. It can occur for weeks, disappear and then return suddenly.
- The most common causes are:
- Head trauma (the most common cause in patients under age 50)
- Degeneration of the inner ear structures
BPPV Diagnosis and Treatment
BPPV is most diagnosed by your doctor when he or she intentionally causes an episode of vertigo. The test performed is the Dix-Hallpike maneuver. During the test, you are moved quickly from a sitting position to lying down with your head tilted to one side and slightly extended beyond the edge of the exam table.
If this triggers vertigo, your doctor can determine if it is a result of BPPV by watching your eye movements. Your doctor can also identify where in the inner ear the otoconia debris is located. If BPPV is diagnosed, a simple technique known as canalith repositioning can resolve the symptoms quickly, with over 90% effectiveness.