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What Is Benign Paroxysmal Positional Vertigo (BPPV)?

Learn about benign paroxysmal positional vertigo, or BPPV, from Ronald A. Hoffman, M.D. in this Howcast video.


Patients who complain of dizziness or vertigo will often be told that they have loose calcium crystals in their inner ear. Your inner ear is a motion sensor, and the way that your inner ear works is that there are little hairs that float in fluid. And when you move or turn, those hairs bend and they send a signal to your brain.

Those hairs have calcium crystals on them, millions of tiny little calcium crystals. Everyone has millions of tiny little calcium crystals. These calcium crystals add mass so that these hairs bend better in a gravity world which is where we live. On occasion, these calcium crystals will break loose and float around. And if you suddenly look up, or bend over, or roll over in bed, the crystals move, they create a little current, they bend the hairs, and the room spins and you have vertigo.

This is called Benign Paroxysmal Positional Vertigo, BPPV. Or, loose calcium crystals in your ear. Benign paroxysmal positional vertigo is the most common cause of dizziness in otherwise healthy adults, and it usually begins when you get up in the morning and you're in bed, because kind of without thinking you roll over or you sit up, and all of a sudden, everything spins.

The diagnosis of benign paroxysmal positional vertigo can often be made by your physician if they look at your eyes while they move your head around. And the treatment for these loose calcium crystals is specific inner ear exercises which can be prescribed for you by either your family physician or an ear, nose, and throat specialist.

The most common cause of Benign paroxysmal positional vertigo or loose calcium crystals is head trauma. The second most common cause is a viral inflammation. The third most common cause is that it happens in conjunction with some other ear disease. And then finally there's a significant group of patients in whom we say, you have it, but we don't know why.

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