What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) occurs when calcium carbonate crystals become dislodged and move into the inner ear, which is responsible for balance control. When the patient moves their head, these crystals shift within the inner ear, causing dizziness. The exact cause of this condition is not fully understood, but several risk factors have been identified, such as aging, head trauma, infections, diabetes, and hypertension.

What are the symptoms of BPPV?

Patients experience vertigo when changing positions, such as lying down, bending forward, or tilting the head backward. They may have difficulty maintaining balance, along with nausea and vomiting. Symptoms typically occur in short episodes during movement and improve when staying still. Patients do not experience hearing loss or other central nervous system abnormalities such as limb weakness or double vision.

How is BPPV diagnosed?

• Medical history taking, including vertigo symptoms, associated symptoms, and triggering factors
• Physical examination such as ear, nose, and throat examination, neurological examination, and the Dix-Hallpike maneuver
• Additional tests to differentiate from other causes of vertigo, such as hearing tests and brain imaging (e.g., MRI) to detect central nervous system abnormalities

Treatment of BPPV

• Symptomatic treatment such as medications to relieve dizziness and avoiding triggering factors
• Physical therapy, including canalith repositioning procedures and vestibular exercises to help the brain adapt more quickly
• Surgery, which is rarely used and considered only in severe cases when medication and physical therapy are ineffective