Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo (BPPV) is a condition where vertigo (a sensation of spinning) is brought on by changing the position of the head (e.g. looking up, bending down, rolling over in bed)
Etiology for Benign Paroxysmal Positional Vertigo
This illustration shows the location of the sediment in the semicircular canals before a repositioning maneuver has been performed.
This illustration shows the location of the sediment in the semicircular canals before a repositioning maneuver has been performed.
Within the utricle of the inner ear, there are calcium carbonate crystals called otoconia that are normally attached to the otolithic membrane in the utricle. When the otoconia detach, changes in head position cause pieces of otoconia, or sediment, to be displaced into the semicircular canals. There are two main types of BPPV: canalithiasis, in which the sediment is free-floating in the semicircular canal and cupulolithiasis, in which the crystals attach to the cupula of the inner ear. BPPV involving the posterior semicircular canal is the most common type due to the position of the canal in relation to the utricle.

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Dr. Sanjay Prasad MD FACS is a board certified physician and surgeon with over thirty-two years of sub-specialty experience in Otology, Neurotology, advanced head and neck oncologic surgery, and cranial base surgery. He is chief surgeon and founder of the private practice, Metropolitan NeuroEar Group, located in the metropolitan Washington D.C. area.