Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common form of positional vertigo and it accounts for

nearly half of all people with a peripheral vestibular system dysfunction.

The prevalence of BPPV in the general population is thought to be 2.4%

but the prevalence increases with age. BPPV is more common in women than men in all age groups.

What is the vestibular system?

The vestibular system compromises five sensory organs that provide

your brain with information about head position and movements. The

five organs include three semicircular canals and two otoliths (the

saccule and utricle). This system, there is one on each side, is also

termed the ‘inner ear’ as it is connected to the cochlea which is part of

the hearing mechanism. The vestibular system provides information to

your brain about head rotational movements, linear movements as well

as static positions of the head relative to gravity.

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What is BPPV?

In the otoliths, there are calcium carbonate crystals or otoconia that

occur naturally. These ‘ear rocks’ are fixed to a membrane within the

saccule and utricle. If they dislodge, they can migrate into one of the

semicircular canals where they don’t belong. If this

happens, then the problem that is caused is termed BPPV.

In BPPV, the dislodged otoconia  can send erroneous information to the brain, creating the sensation of vertigo (spinning), abnormal eye movement (nystagmus), and nausea. 

How is BPPV treated?

Most BPPV involves loose or free floating otoconia in the posterior

semicircular canal of the vestibular system. Sometimes the otoconia can

be in the horizontal semicircular canal. The basis of all of the treatment

techniques is to move or ‘float’ the loose otoconia around the

semicircular canal in order to reposition them in the saccule where they