Benign Paroxysmal Positional Vertigo Overview

Benign Paroxysmal Positional Vertigo Overview

By Brett Adams, Au.D.


Serving as the most common cause of vertigo in adults, BPPV is a condition that presents with severe symptoms of environmental spinning, triggered by positional changes. These symptoms can begin suddenly and can persist until a treatment is performed by an audiologist or physical therapist. This is a common problem that we commonly identify among dizziness patients at SWENT. Feeling as though the room is rapidly spinning, and being unsure of the reason, is a stressful and anxious experience. Here, we will share some information about the anatomical causes behind the condition, and the treatment options available to alleviate the symptoms.


First, understanding the anatomy of the inner ear vestibular system can shed some light on the origins of the problem. The inner ear mechanism of balance provides the brain with essential information about the body’s linear movement (performed by the otolith organs, utricle and saccule), as well as angular acceleration (via the semi-circular canals). Within the otoliths (specifically the utricle, in the case of BPPV), calcium carbonate crystals adhere to a gelatinous membrane, which move in coordination with linear body movements (think of the feeling of rising in an elevator or moving forward in an accelerating car). Sometimes due to head trauma, illness, or spontaneously, these crystals can migrate from their original resting position in the utricle into the semi-circular canals. When this occurs, angular movement of the head can cause these displaced crystals can abnormally stimulate receptors in the canals, simulating a sensation of severe spinning.


These crystals, called otoconia, can find their way into three possible locations in either ear, or can be present in multiple locations simultaneously. For this reason, it is recommended to visit an ear, nose & throat physician (otolaryngologist) to help diagnose the condition and location of displaced otoconia, before trying any home treatment maneuvers.


In order to relieve the patient of BPPV symptoms, the goal is simply to remove displaced debris from the semi-circular canals, back into their original position within the utricle. Depending on where the otoconia is within the vestibular system, the treatment maneuver will be different. Therefore, home treatments that you may find on the internet are far from a “one size fits all” model. Outcomes for BPPV treatment maneuvers have a high success rate, when follow-up precautions and sleeping position recommendations are followed for at least 48 hours after treatments.


At Southwestern Ear, Nose & Throat, we offer in-house treatments for BPPV, at our Santa Fe facility. If you are experiencing similar symptoms of positional vertigo, or are interested in obtaining more information about other forms of dizziness or instability, please contact Southwestern Ear, Nose & Throat to schedule a consultation.