A question has been asked on Quora regarding BPPV. I’m including my answer here, and a more detailed explanation of this condition:

Please explain BPPV (benign paroxysmal positional vertigo) in detail with it’s effective treatments?

Benign paroxysmal positional vertigo is one of the simplest causes of vertigo. When people say they have vertigo, they may be referring to slight dizziness/giddiness on getting up, a fainting attack, or a true positional vertigo where a person feels as if everything he sees is rotating around. The latter is most commonly seen on getting up from bed after an interrupted sleep.

The vertigo is quite debilitating, People often think they are suffering some serious disorders of the brain. But BPPV is one of the simplest causes of vertigo. If you want the real cause, I would simplify it and say that there are organs within your inner ear that control balance. These organs contain some calcium crystals that are supposed to lie within certain parts of the ear. Due to a variety of causes, they become misplaced, and cause unnecessary and wrongful stimulation of a person’s balance system. The brain thinks that the person is moving even when he isnt moving. Unfortunately the brain tries to correct the movement, causing the eyes to move back and forth, causing vertigo.

That’s as simple as I can make it. If you want the more technical explanation, it is due to canalolithiasis and cupulolithiasis.

The most effective treatment of BPPV is a simple Epley’s manouevre, which is a kind of exercise that the affected person is made to do by an ENT speciliast. At our clinic, we do only Epley’s manouevre for BPPV, and we’ve noted effective resolution in all cases. Sometimes more than one manouvre may need to be performed.

Details regarding BPPV:

Key Points

  • Benign paroxysmal positional vertigo is a peripheral vestibular disorder and the most commonly diagnosed type of vertigo
    • Caused by displaced calcium carbonate debris from otoconia within the utricle into semicircular canal(s)
    • Posterior semicircular canal is primarily affected (85%-95% of cases); lateral semicircular canal affected in 5% to 15% of cases; anterior canal is rarely affected (1%-2% of cases) 1
  • Characterized by repeated, brief episodes of vertigo that are triggered by changes in head position relative to gravity
  • Diagnose benign paroxysmal positional vertigo based on compatible history and physical examination
    • Diagnostic maneuvers used to precipitate vertigo and characteristic nystagmus based on anatomic location of otolithic debris
      • Diagnose posterior canal benign paroxysmal positional vertigo with Dix-Hallpike maneuver
      • Diagnose lateral canal benign paroxysmal positional vertigo with supine head roll test
  • Radiographic imaging and/or vestibular testing is not routinely recommended
  • Treat by performing particle repositioning procedures to provide immediate relief of symptoms
    • Procedure determined by semicircular canal affected
      • Posterior canal benign paroxysmal positional vertigo: use Epley or Semont maneuver
      • Lateral canal benign paroxysmal positional vertigo: several maneuvers available (eg, roll maneuver, Gufoni maneuver, forced prolonged positioning)
  • Routine treatment with vestibular suppressant medications (eg, antihistamines, benzodiazepines) is not recommended
  • Self-limited disease; spontaneous recurrences and remissions are frequent

Clinical Clarification

  • Benign paroxysmal positional vertigo is a disorder of the inner ear characterized by repeated episodes of positional vertigo 1
    • Most common cause of vertigo 2 (illusory sensation of movement, typically rotational, of self or surroundings)
    • Episodes of vertigo are brief and triggered by changes in head position relative to gravity 1
  • Previously used terms include benign positional vertigo and paroxysmal positional vertigo

Classification

  • Based on anatomic location
    • Most commonly encountered as 1 of 2 variations: 1
      • Posterior semicircular canal benign paroxysmal positional vertigo (approximately 85%-95% of cases)
      • Lateral semicircular canal (also referred to as the horizontal canal) benign paroxysmal positional vertigo (approximately 5%-15% of cases)
    • Rare variations include: 1
      • Anterior semicircular canal (also referred to as the superior canal) benign paroxysmal positional vertigo (approximately 1%-3% of cases)
      • Multiple semicircular canal benign paroxysmal positional vertigo
        • Most common combination is the posterior and lateral semicircular canals 3
      • Bilateral multiple canal benign paroxysmal positional vertigo
        • Majority are posttraumatic