Benign paroxysmal positional vertigo

Overview


Plain-Language Overview

Benign paroxysmal positional vertigo (BPPV) is a common disorder affecting the inner ear, which helps control balance. It causes brief episodes of dizziness or a spinning sensation triggered by changes in head position. This happens because tiny calcium crystals called otoconia become dislodged and move into the semicircular canals, disrupting normal fluid movement. The main symptoms include sudden, intense vertigo lasting seconds to minutes, often when looking up or rolling over in bed. Although uncomfortable, BPPV does not cause hearing loss or permanent damage. It primarily affects the vestibular system, which is responsible for sensing motion and maintaining equilibrium.

Clinical Definition

Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder characterized by brief episodes of vertigo triggered by specific changes in head position relative to gravity. The core pathology involves displacement of otoconia from the utricle into one or more semicircular canals, most commonly the posterior canal, causing abnormal endolymph fluid movement and inappropriate stimulation of the vestibular hair cells. This leads to transient vertigo and characteristic nystagmus. BPPV is usually idiopathic but can follow head trauma, vestibular neuritis, or prolonged bed rest. It is the most common cause of peripheral vertigo and is clinically significant due to its impact on balance and risk of falls. Diagnosis relies on clinical history and positional testing. The condition is termed benign because it is not life-threatening and often resolves with appropriate maneuvers.

Clinical Presentation


Diagnostic Workup


Pathophysiology


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Differential Diagnoses


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