Benign Paroxysmal Positioning Vertigo
Benign paroxysmal positioning vertigo (BPPV) is the commonest cause of vertigo related to inner ear dysfunction. It means literally harmless short attacks of vertigo associated with particular head movements. The term "benign" has historic use but is probably not appropriate.
The problem is mostly caused by stray debris inside the inner ear creating a viscous drag on the normally functioning balance organs (cupulae) that detect rotation of the head. This compromises normal perception of movement through the environment and can create feelings of nausea, vomiting and ultimately falls. The source of the debris is likely another inner ear balance organ, the utricle. The particles are termed "otoconia".
BPPV may or may not be associated with hearing loss.
BPPV patients are referred to the ENT Department where in most cases a simple repositioning of the stray particles can be successfully performed by manoeuvring the patient's head while lying down. The debris is usually then metabolised by the inner ear, however the underlying cause for the existence of the stray debris will be important to understanding how best to manage the patient's interest and may explain other accompanying symptoms requiring attention.
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