Dizziness and Vertigo / Vestibular Rehab

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common form of positional vertigo and it accounts for nearly half of all people with a peripheral vestibular system dysfunction.

The prevalence of BPPV in the general population is thought to be 2.4% but the prevalence increases with age. BPPV is more common in women than men in all age groups.


What is the vestibular system?

The vestibular system compromises five sensory organs that provide your brain with information about head position and movements. The five organs include three semicircular canals and two otoliths (the saccule and utricle). This system, there is one on each side, is also termed the ‘inner ear’ as it is connected to the cochlea which is part of the hearing mechanism. The vestibular system provides information to your brain about head rotational movements, linear movements as well

as static positions of the head relative to gravity.

What is BPPV?

In the otoliths, there are calcium carbonate crystals or otoconia that occur naturally. These ‘ear rocks’ are fixed to a membrane within the saccule and utricle. If they dislodge, they can migrate into one of the semicircular canals where they don’t belong. If this happens, then the problem that is caused is termed BPPV.

In BPPV, the dislodged otoconia  can send erroneous information to the brain, creating the sensation of vertigo (spinning), abnormal eye movement (nystagmus), and nausea. 


How is BPPV treated?

Most BPPV involves loose or free floating otoconia in the posterior semicircular canal of the vestibular system. Sometimes the otoconia can be in the horizontal semicircular canal. The basis of all of the treatment

techniques is to move or ‘float’ the loose otoconia around the semicircular canal in order to reposition them in the saccule where they belong.