Vertigo, defined as a perception of movement where the individual or the individual’s surroundings seem to whirl dizzily, is usually a rather uncomfortable experience. It can alter your balance, leading to falls which can be dangerous in the elderly, and can be combined with dizziness, a sensation that you’re falling or spinning, and in serious instances migraine headaches, nausea, vomiting, vision problems (nystagmus), and even fainting spells.

There can be many root causes for vertigo, but one variety of it – benign paroxysmal positional vertigo, or BPPV – relates to your sense of hearing. BPPV arises as the result of naturally-forming calcium crystals known as otoliths or otoconia, that usually cause no issues. For those who have benign paroxysmal positional vertigo, however, these crystals travel from their normal position into one of the semicircular canals of the inner ear, which are crucial for our sense of balance. When this occurs, and the individual with benign paroxysmal positional vertigo reorients their head relative to gravity, these crystals move about, and cause an abnormal displacement of endolymph fluid, which leads to vertigo.

Benign paroxysmal positional vertigo can be brought on by such common movements as turning or tilting your head, looking up and down, and rolling over in bed, and is characterized by the episodic (paroxysmal) nature of the episodes. Changes in barometric pressure, sleep disorders and anxiety can make the symptoms worse. The disorder can present itself at any age, but it most commonly appears in individuals over age 60. The specific cause of BPPV is difficult to determine for any given individual, but sometimes it can be triggered by a blow to the head.

Benign paroxysmal positional vertigo is differentiated from other types of vertigo or dizziness in that it is almost always prompted by head movements, and in that its effects usually subside less than a minute. Vertigo specialists usually diagnose BPPV by having the individual lie on their back on an examination table, rotating their head to one side or over the edge of the table to observe whether this action sets off an episode. More comprehensive tests can be used in certain cases including videonystagmography (VNG), electronystagmography (ENG) and magnetic resonance imaging (MRI). ENG and VNG test for abnormal eye movements while MRI is used to rule out other potential causes of vertigo such as tumors or brain abnormalities.

Benign paroxysmal positional vertigo is generally treated using a technique called canalith repositioning which guides the crystals to a position in the inner ear where there are less problematic using a series of physical motions. Two forms of canalith repositioning that may be used are the Epley maneuver and the Semont maneuver. In some cases (less than 10 percent), if these treatment methods do not provide relief, surgery can be proposed. If you suspect BPPV or have been suffering from vertigo or dizziness for more than 7 days, visit a specialist familiar with balance and vertigo disorders.

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