What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) is an inner ear disorder in which changes to the position of the head, such as tipping the head backward, lead to sudden vertigo – a feeling that the room is spinning. Vertigo can vary in intensity from mild to severe and usually lasts only a few minutes. It may be accompanied by other symptoms, including

Anatomy of the right inner ear.

Particle repositioning therapy moves the otoconia out of the semicircular canals and into the utricle where they dissolve naturally.

BPPV is not a sign of a serious problem, and it usually disappears on its own within 6 weeks of the first episode. However, the symptoms of BPPV can be very frightening and may be dangerous, especially in older individuals. The unsteadiness associated with BPPV can lead to falls. About half of all people over age 65 experience an episode of BPPV, and falls are a leading cause of fractures in this age-range.

What causes Benign Paroxysmal Positional Vertigo (BPPV)?

BPPV develops when calcium carbonate crystals, which are known as otoconia, shift into and become trapped within the semicircular canals (one of the vestibular organs of the inner ear that controls balance). The otoconia make up a normal part of the structure of the utricle, a vestibular organ next to the semicircular canals. (see illustration to the right.)

In the utricle, the otoconia may be loosened as a result of injury, infection, or age, and they land in a sac – the utricle – where they are naturally dissolved. However, otoconia in the semicircular canals will not dissolve. As a person’s head position changes, the otoconia begin to roll around and push on the tiny hairs that line the semicircular canals. Those hairs act as sensors to give the brain information about balance. Vertigo develops when the hairs are stimulated by the rolling otoconia.

What head positions trigger Benign Paroxysmal Positional Vertigo (BPPV)?

Movements that can trigger an episode of BPPV include rolling over or sitting up in bed, bending the head forward to look down, or tipping the head backward. In most people, only a single ear is affected by BPPV, although both ears may be involved on occasion.