Benign Paroxysmal Positional Vertigo

(BPPV; Benign Positional Vertigo, BPV; Positional Vertigo of Barany)

Definition

Vertigo is a feeling of movement or spinning when you are still. Benign paroxysmal positional vertigo (BPPV) happens when the vertigo is caused by changes in the position of the head. This might include standing after bending down, turning the head in bed, or extending the neck to look up. People with BPPV can often identify which moves cause the most problems.

Causes

The inner ear contains tiny crystals. These crystals can sense movement and help you keep your balance. BPPV occurs because of a shift in location of these crystals or the clumping of these crystals. When this happens, your brain gets signals that you are moving when you are really not moving. This causes the feeling of movement.
Inner Ear
Inner ear deposits
The clump of ear crystals can lead to BPPV.
Copyright © Nucleus Medical Media, Inc.
In some cases, the cause of BPPV is unknown. In others, it may be caused by:
  • Head injury
  • Viral infection
  • Disorders of the inner ear
  • Prolonged immobility of the head
  • Age-related changes to inner ear

Risk Factors

Increasing age increases your chances of getting BPPV.

Symptoms

Symptoms may include:
  • Sensation of spinning or rotation when you change head position that last less than one minute
  • Loss of balance
  • Nausea
  • Vomiting
  • Ringing or buzzing sounds in the ear
  • Vision or hearing problems

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Part of the process will be to eliminate other disorders. Your doctor may recommend tests to help determine the cause of vertigo symptoms. Tests may include:
  • Blood pressure test, both lying down and standing up
  • Blood tests
  • Auditory tests
  • Vision tests
  • Dix-Hallpike maneuver—moving your head or body in certain ways to test response
  • MRI scan
  • Electronystagmography (ENG)

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