Vertigo – the perception of movement in which the individual or the individual’s surroundings appear to spin and move – is, typically an undesirable event. The feelings of vertigo sometimes include spinning or falling sensations and dizziness. When vertigo impacts balance, it can lead to falls and injuries – particularly in the elderly. More extreme cases can also cause vomiting, nausea, migraine headaches, visual abnormalities known as nystagmus and fainting.

There are various distinct types of vertigo with varied root causes. Audiologists frequently encounter benign paroxysmal positional vertigo, or BPPV, since it is related to your sense of hearing. BPPV arises from calcium crystals that form naturally called otoconia or otoliths, which usually cause no problems. In individuals who are afflicted with BPPV, however, these crystals become dislodged from their normal location and travel into one of the semicircular canals of the inner ear that govern our sense of balance. Once they are within the semicircular canals, the crystals cause an abnormal displacement of endolymph fluid every time a person reorients their head (relative to gravity). This is the underlying cause of the vertigo feelings in cases of benign paroxysmal positional vertigo.

BPPV can be triggered by such common actions as tilting or turning your head, rolling over in bed, and looking up or down, and is characterized by the brief (paroxysmal) nature of the attacks. These symptoms can be worsened by lack of sleep, stress, or changes in barometric pressure, such as occur before snow or rain. The disorder can present itself at any age, however it typically appears in people over 60 years of age. The specific cause of BPPV is difficult to determine for any given person, but from time to time it is brought on by a blow to the head.

Benign paroxysmal positional vertigo is differentiated from other types of dizziness or vertigo in that it is practically always brought on by head movements, and in that its symptoms usually decrease in less than a minute. Physicians may diagnose it by having the patient rest on their back and then tip their head to one side or over the edge of the exam table. Additional tests that can be used to diagnose benign paroxysmal positional vertigo include videonystagmography or electronystagmography, which test for abnormal eye movement, and magnetic resonance imaging (MRI), whose primary role is to rule out other possible causes, such as brain abnormalities or tumors.

There is no complete cure for BPPV, but it can be effectively treated using canalith repositioning (either the Epley maneuver or the Semont maneuver), both of which use physical movements to guide the crystals to an area in which they no longer cause trouble.In rare cases (under 10%), if these treatments do not provide relief, surgery may be proposed. See your health care provider if you have experienced symptoms which sound as if they might be related to BPPV, especially if they last for more than a week.