Benign Paroxysmal Positional Vertigo (BPPV)
Benign paroxysmal positional vertigo (BPPV) is a balance disorder that results in the sudden onset of dizziness, spinning, or vertigo when moving the head. BPPV is thought to be due to debris which has collected within a part of the inner ear. This debris can be thought of as “ear rocks.” although the formal name is “otoconia.” They are probably dissolved naturally as well as actively reabsorbed by the “dark cells” of the labyrinth which are found adjacent to the utricle and the crista, although this idea is not accepted by all. About 20% of all dizziness is due to BPPV. The older you are, the more likely it is that your dizziness is due to BPPV, as about 50% of all dizziness in older people is due to BPPV. In a recent study, 9% of a group of urban dwelling elders were found to have undiagnosed BPPV. Getting out of bed or rolling over in bed are common “problem” motions . Because people with BPPV often feel dizzy and unsteady when they tip their heads back to look up, sometimes BPPV is called “top shelf vertigo.” An intermittent pattern is common. BPPV may be present for a few weeks, then stop, then come back again. The most common cause of BPPV in people under age 50 is head injury. There is also an association with migraine (Ishiyama et al, 2000). In older people, the most common cause is degeneration of the vestibular system of the inner ear.