MUSC: Benign Paroxysmal Positional Vertigo (BPPV)


BPPV, Benign paroxysmal positional vertigo, is the most frequent cause of dizziness, up to 20 percent of the causes of dizziness, and is related to the displacement of motion sensors in the inner ear balance organ from the thin membrane that they usually lie on into the fluids of the balance organs. This happens because of a trauma, because of an infection, because of chronic headaches or chronic illnesses. Most of the time we cannot specifically attribute it to a cause. There are three types of BPPV depending on which balance canal is affected; the posterior, the lateral, or the superior, and the maneuvers that we use to treat are different for each one. Once these crystals fall into the fluids, they start giving the brain false information of motion because they are stimulating the balance organ inappropriately. And this happens mostly when the patient changes certain positions of their head. The most frequent type of BPPV is one that happens once the patient lies down and looks over to the right or to the left side. These are short lived spinning sensations that are sometimes accompanied
by nausea and vomiting. Infrequently in patients who have chronic BPPV, the patient can complain of imbalance, lightheadedness, non-specific dizziness that is not actually a spinning sensation.

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