This is because the scattered otoconia eventually work their way back to the jelly layer that they became dislodged from. When people develop BPPV, they may experience many brief episodes in a day for several days to weeks, but over time, the episodes become less and less frequent until they disappear altogether. People are usually normal in between episodes. It may also occur when looking up to reach something from a cupboard, bending over to tie one’s shoes or similar situations.Įpisodes of vertigo are typically brief, lasting from a few seconds to up to a minute and are rarely longer, even though it may feel that way during an attack. Classically it occurs in bed when a person turns over from one side to the other, and this is by far how the most common description given by people who suffer from it. The canal that they are in will determine the head positions that are more likely to aggravate symptoms. BPPV occurs in one ear in most cases, but in about 10% or cases, both ears are involved.īPPV causes short episodes of vertigo that are aggravated by a change in the position of the head. They can then stimulate the canal and cause the sensation of spinning (vertigo). When they become dislodged, they break free of the jelly layer and float around the fluid within the one or more of the semicircular canals (usually the posterior canal). In the healthy ear, the otoconia lie suspended in a layer or jelly at the junction where the three semicircular canals meet and are important in helping us to sense changes in gravity and head position. Indeed, many patients with Ménière’s disease will additionally develop BPPV at some time during the course of their illness. It can also be aggravated by other conditions affecting the inner ear, such as Ménière’s disease or labyrinthitis. Most cases occur without any precipitating events and come on ‘out of the blue’, but they can also be caused by violent head trauma, a bad viral illness or having the head in certain positions for long periods of time (for example it can happen after certain long operations when a patient has been lying flat for a long time). Approximately 50% of people will experience BPPV in their lifetime. People of all ages can get BPPV, but it is more common in older people. Though disabling at times, BPPV is not a dangerous condition. Vertigo always involves the sensation of spinning and is very different from ‘dizziness’, which is used to describe a lot of different sensations including the feeling of lightheadedness, ‘fuzziness’ or oscillopsia (the feeling of being on a ship at sea). Otoconia (also called otoliths, ear crystals or ear stones) are tiny crystals of calcium carbonate (chalk) that, together with several other factors, are important in maintaining a person’s balance.īPPV is so called because it is Benign (self-limiting), Paroxysmal (comes on suddenly without warning), Positional (aggravated by certain head positions) and a cause of Vertigo (the sensation of spinning, as if having just stepped off a merry-go-round). BPPV is a condition where episodes of vertigo are caused by dislodgement of the otoconia (this is the plural of otoconium) from their normal position within the inner ear.
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