Benign Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is a common diagnosis for those
who suffer from vertigo. Approximately one-third of all vertigo cases are
diagnosed as BPPV. Symptoms of BPPV include dizziness, lightheadedness,
imbalance and nausea.

BPPV is not the result of a serious pathological condition. Rather, it is caused when crystals of
calcium carbonate known as otoconia (ear rocks) migrate from their normal
position into the semicircular canals of the inner ear . Normally, fluid moves
in the canals when the head is turned. An ear rock immersed in the fluid of the
canal can disrupt normal balance receptors when the head turns, rotates or bends.
This causes information from one side of the head to be different from the
other. The result is BPPV.

A thorough examination is needed to rule out pathological causes of
dizziness, such as stroke, severe hypertension, diabetes, tumors and viral
infections.

The primary test used to diagnose BPPV is the Dix-Hallpike manuver. In this
test, a person lays down with their head turned 45 degrees to one side and
extended about 20 degrees backward. A positive Dix-Hallpike test is noted
when a burst of nystagmus occurs: The eyes jump upward and twist so that the
top part of the eye jumps toward the down side.


There is a good chance of full recovery from BPPV. We use an ear rock
repositioning techniqe called Epleys Maneuver, which will be the subject of
another post.