BPPV presents with the following symptoms:
Symptoms appear suddenly, such as when the patient tries to sit up after sleep, when there is sudden tilting of the head to see something above, etc. and go away rapidly too.
Work up consists of a detailed history and physical examination.
Imaging studies are not required to diagnose BPPV. A CT scan , however, may be conducted if needed to check for other suspected pathologies.
A physical examination and history are sufficient to diagnose BPPV.
Canalith repositioning procedure
The Epley maneuver is done by a series of 4 movements of the head. After each movement, the head is held at the same place for 30 seconds or so . This is a highly effective, risk-free and non invasive mode of treatment and considered the treatment of choice for BPPV. There are other maneuvers also that are included in the CRP but are less effective and less popular than the Epley maneuver.
These are not very effective as they do not treat the condition but just provide temporary relief.
This is the last mode of treatment reserved only for those patients in whom CRP (canalith repositioning procedure) has completely failed and who suffer from very severe episode of vertigo that greatly compromise quality of life.
As the name indicates, BPPV comes and goes. It may get triggered due to movement and an episode of vertigo may occur. In most cases, BPPV can be treated by the Epley maneuver and prognosis is very good. In some cases, episodic recurrence may happen.
BPPV occurs due to a defect in the inner ear. Recall that the inner ear has fluid filled semicircular canals and otoliths. A small fragment of the otolith may break apart and its motion brought upon by movement of the head, may send inappropriate signals to the brain regarding the body's balance and position.
Other causes include age related wear and tear of the inner ear, trauma to the ear which damages the vestibular organs, ear diseases such as otosclerosis, otitis media and Meniere disease. CNS diseases may cause secondary BPPV. However, up to 39% of cases are idiopathic.
Approximately 18% of patients seen in dizziness clinics  and 25% of patients seen for vestibular testing have BPPV .
Although BPPV can occur at any age, it most commonly presents in patients aged 60 and above. BPPV also accounts for about 20% of paediatric referrals .
BPPV shows a distinct predisposition in females (up to 64% some studies reveal).
BPPV has no known predisposition to any race or ethnic group.
BPPV is an abnormal sensation of motion that is brought upon by certain movements of the head and/or eyes. These movements or positions may lead to nystagmus which then leads to dizziness and vertigo.
The sensation of fluid moving in the semicircular tubes tells the brain the position of the body . If these sensations are abnormal, they may send wrong or mixed signals to the brain and dizziness and vertigo may be triggered.
Patients may want to adjust their sleeping positions accordingly to prevent recurrence . Rehabilitation may prove to be helpful and slight changes in daily behaviour and routine may help in preventing recurrence of BPPV.
Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo. Its symptoms are repeated episodes of positional vertigo, that is of a spinning sensation caused by changes in the position of the head . It is due to a defect in the inner ear which may occur due to a number of causes and this condition may act as a source of discomfort for a life time in some cases.
BPPV is the most common type of vertigo that occurs due to inner ear defects.
BPPV can be treated by physical maneuvers performed by trained professionals and in severe cases, surgery can provide relief.
BPPV is triggered due to unprecedented movement of the head and/or eyes so it can be prevented by modifying movements and sleeping positions.