Vertigo – a perception of movement in which the individual or the individual’s surroundings seem to spin and move – is, generally an unpleasant event. The feelings of vertigo occasionally include dizziness, spinning or falling. Any time vertigo impacts balance, it can lead to falls and accidental injuries – especially in older adults. More serious cases may also trigger nausea, vomiting, migraine headaches, fainting and visual irregularities called nystagmus.

There can be many causes for vertigo, but one kind of it – benign paroxysmal positional vertigo, or BPPV – relates to hearing. BPPV occurs from calcium crystals that form naturally known as otoliths or otoconia, which in most people cause no problems. In benign paroxysmal positional vertigo, the crystals travel from their normal locations into the semicircular canals of the inner ear. When this occurs, and the individual with BPPV changes the orientation of their head relative to gravity, these crystals move around, resulting in an abnormal displacement of endolymph fluid, which leads to vertigo.

Everyday actions such as tilting your head, looking up and down or rolling over in bed can bring about the benign paroxysmal positional vertigo. The vertigo sensation comes on very suddenly and has a short duration. These symptoms can be made worse by lack of sleep, anxiety, or changes in barometric pressure, such as occur before rain or snow. The condition can manifest itself at any age, but it most commonly appears in people over age 60. The initial trigger for the benign paroxysmal positional vertigo is typically difficult to determine. A sudden blow to the head (for example in an automobile accident) is among the more well-known causes.

Benign paroxysmal positional vertigo is different from other forms of dizziness or vertigo because the episodes are transient (typically under a minute), and because it is always triggered by head movements. Vertigo specialists may diagnose it by having the patient rest on their back and then tilt their head to one side or over the edge of the examination table. Additional tests which can be used to diagnose benign paroxysmal positional vertigo include videonystagmography or electronystagmography, which test for abnormal eye movement, and magnetic resonance imaging (MRI), whose primary role is to eliminate other potential causes, such as brain abnormalities or tumors.

There is no full cure for benign paroxysmal positional vertigo, but it can be effectively treated using canalith repositioning (either the Semont maneuver or the Epley maneuver), both of which use bodily movements to shift the crystals to a position in which they no longer cause trouble.Surgical treatment is an option in the exceptional cases in which these treatments are ineffective. See your health care provider if you have felt symptoms which sound as if they could be related to BPPV, especially if they persist for more than a week.